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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313622563
Report Date: 08/13/2019
Date Signed: 08/13/2019 09:45:50 AM

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:BARRETT, KRISTENFACILITY NUMBER:
313622563
ADMINISTRATOR:BARRETT, KRISTENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 838-9494
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:14CENSUS: 12DATE:
08/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Kristen Barrett - LicenseeTIME COMPLETED:
09:45 AM
NARRATIVE
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An unannounced annual/random inspection is made today by LPA Owens. Present at time of inspection were licensee, her assistant and 12 day care children. Ages of children present were 3,3,3,3,3,3,3,3,3,2,2,2. Licensee is not a Foster Parent, nor have any other licenses.

A tour of the home, inside and outside, as shown on the facility sketch is conducted. Staff and Children were spoken to during inspection. There are no "bodies of water" at this home. Licensee states there are no weapons or firearms in the home. LPA observed poisons, cleaning compound's, medications and other hazardous items are inaccessible to children. Fireplace contains a screen, and is inaccessible to children. Fire extinguisher, Carbon Monoxide detector and smoke detector meets regulations. Currently, licensee does have 1 dog that is inaccessible to children; the dog is in an off limit area. There are sheep, goats and chickens that are in the backyard play area. She chooses to allow the children to feed the sheep, goat and chickens and she is aware that she is responsible for child safety around pets at all times. There are no stairs in the home. Safe toys and play equipment are observed. There is a working telephone. Adequate supervision is being provided during this inspection. Children are supervised when outside in the unfenced play area.

The capacity as specified on the license is being maintained. Staff-child ratios are maintained. 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 is current with expiration date of 4/7/2020. A child roster is maintained. Fire and disaster drills are conducted every six months and documented. Some staff and children records reviewed.
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SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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 2
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: BARRETT, KRISTEN
FACILITY NUMBER: 313622563
VISIT DATE: 08/13/2019
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LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.

LPA observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com

LPA discussed the new Safe Sleep in Child Care regulation and gave licensee the brochure.

Off-limit rooms are: Living room, All bedrooms and private patio.. Licensee acknowledges that children may never enter these off-limit areas. Swing set observed and is anchored into ground. Observed tool shed in backyard and it behind a fence.



During the exit interview, LPA discussed AB 633, Parent Notification Requirements, and the posting of licensing inspection notices and reports. Hours of operation are 8:30 AM to 3:00 PM; Monday thru Friday and other hours as arranged. Facility is closed on Christmas break and Summer end of July until mid August. (follow school district schedule).
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 in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, NO deficiencies are observed today. This report was reviewed and discussed
with licensee at time of inspection. Licensee have read and understands the content of this report.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
LIC809 (FAS) - (06/04)
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