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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293602570
Report Date: 01/30/2020
Date Signed: 01/30/2020 02:49:49 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:BROWN, FREDENEFACILITY NUMBER:
293602570
ADMINISTRATOR:BROWN, FREDENEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 320-2991
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY:14CENSUS: 14DATE:
01/30/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Fredene BrownTIME COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Lea Habtom and Amanda Blesi met with licensee Fredene Brown for an unannounced annual/random inspection. Present at the time of inspection was licensee, her assistant Keith Brown and 14 day care children.

A tour of the home, inside and outside, was conducted. Stairs are barricaded when children under age 5 years old are present. Off-limit rooms are: Entire upstairs Licensee acknowledges that children may never enter these off-limit areas.

Licensee states there are no weapons or firearms in the home. There are no body of waters. LPA observed hazardous items (detergents, cleaning compounds, medication, sharp utensils, and other items that could pose a danger to children in care) are properly stored out of children's reach. An exemption was granted for the fireplace. There is a working telephone. Fire extinguisher, carbon monoxide detector and smoke detector meet regulations. Toys and play equipment that were observed appear to be safe.

Adequate supervision is being provided during this inspection. The capacity as specified on the license is maintained. Staff-child ratios were not maintained due to 14 children in care and none were school age. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Pediatric CPR/FA was taken on January 25, 2020 and licensee is waiting for card to be mailed. A child roster is maintained. Fire and disaster drills are conducted every six months and documented. Children records reviewed.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea HabtomTELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BROWN, FREDENE
FACILITY NUMBER: 293602570
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/30/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/31/2020
Section Cited

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A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met: At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.
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This requirement was not met as evidenced by: LPA observed 14 children in care today. None of the children were school age. This is an immediate risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea HabtomTELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:
DATE: 01/30/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/30/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: BROWN, FREDENE
FACILITY NUMBER: 293602570
VISIT DATE: 01/30/2020
NARRATIVE
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Licensee and assistant Keith Brown failed to provide proof of immunization's therefore did not met the requirements of SB 792.

LPA did not observe proof of mandated reporter training for licensee and Keith Brown (AB 1207) at website: www.mandatedreporterca.com

LPA discussed the new Safe Sleep in Child Care regulation. LPA discussed and gave licensee the Effects of Lead Exposure brochure.


This facility is not providing Incidental Medical Services-IMS at this time.

Hours of operation are 6:00 AM to 5:45 PM; Monday to Friday and other hours as arranged.

Licensee states she does not transport children.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current regarding new regulations. LPA also included the email address for the child care advocates program so licensee can request to be added to the distribution list to receive Quarterly Updates. childcareadvocatesprogram@dss.ca.gov.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, NO deficiencies were observed today. This report was reviewed and discussed
with licensee at time of inspection.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea HabtomTELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BROWN, FREDENE
FACILITY NUMBER: 293602570
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/30/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2020
Section Cited

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(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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This requirement was not met as evidence licensee and spouse Keith Brown failed to provode written proof of immunizations records for measles, pertussis and flu.
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Type B
02/28/2020
Section Cited

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Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion
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This requirement was not met as evidenced by LPA: licensee and spouse Keith Brown failed to provide proof of mandated reporter training.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea HabtomTELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:
DATE: 01/30/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/30/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4