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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843705
Report Date: 10/16/2023
Date Signed: 10/16/2023 05:55:06 PM


Document Has Been Signed on 10/16/2023 05:55 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:KNOWLES FAMILY CHILD CAREFACILITY NUMBER:
334843705
ADMINISTRATOR:CRYSTAL KNOWLESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 682-9066
CITY:RIVERSIDESTATE: CAZIP CODE:
92508
CAPACITY:14CENSUS: 2DATE:
10/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Licensee Crystal KnowlesTIME COMPLETED:
06:05 PM
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On 10/16/2023 at 2:30 PM Licensing Program Analyst (LPA) Susan Brewer arrived at the facility to conduct an annual inspection. LPA was greeted by Licensee Crystal Knowles and granted entry to tour the facility inside and out. LPA reviewed records and observed and/or discussed the following: The licensee and 2 adults present at the home and a resident child. The licensee agrees to update the LIC279 Application form, the LIC610 Emergency Disaster plan 2nd relocation site, the LIC999A Facility Sketches for the Home and Yard, with the reported changes discussed during the annual inspection. The licensee has changed the days and hours of operation as indicated below.

Normal days and hours of operation are Monday- Saturday, 7:00 AM to 6:00 PM.
OFF-LIMIT AREAS INCLUDE: Garage, 1st Floor Bedroom #5 and the Entire 2nd Floor.

The inspection consisted of reviews of the following domain: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio and Capacity, Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D.

·The facility is operating within the licensed capacity and appropriate ratios. LPA took a census of 2 children in care.
· The Licensee is present in the home and has ensured that children in care are supervised.
· When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children.
· A working telephone is present.
· A fully charged fire extinguisher (2A:10BC) was observed and tagged by the fire department and needle in the green. A smoke detector and carbon monoxide detector were present and tested by the licensee during this inspection and the carbon monoxide detector is not working properly and may need to be replaced.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KNOWLES FAMILY CHILD CARE
FACILITY NUMBER: 334843705
VISIT DATE: 10/16/2023
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· All hazardous items are NOT inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children. At 3:32 PM LPA S. Brewer, observed hygiene products and cleaning supplies observed in the children's restroom medicine cabinet, under the vanity, not locked or latched and in the garage.
· Storage of poisons are NOT inaccessible to children and are NOT locked. At 4:06 PM LPA observed items stored under the kitchen sink, such as Raid insect/bug killers and cleaning supplies, which were not locked. The licensee removed all items in the presence of the LPA, however the garage door only has a lower level latch and which is not a lock.
· No fire place in the home
· No guns or weapons present as stated by the Licensee. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations.
· Stairs are barricaded on 10/16/2023.
· Home is clean and orderly, with heating and ventilation for safety and comfort.
· Clean, Safe and age-appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced and/ or appropriate supervision is present.
· Verification of control of property on file by rental agreement.
· Property owner/landlord notification and consent on file 3/08/2016.
· Pediatric CPR and First Aid training on 04/17/2023; Card expires on 04/2025.
· Health & Safety Certificate - completed on 08/26/2016.
· Mandated reporter General: 02/02/2022; AB 1207 Child Care Expires: NOT ON FILE
· Fire clearance: 05/25/2016.
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 10/16/2023 at 4:15 PM, during the inspection with 2 children present.
· There are no bodies of water, 10/16/2023. Licensee Crystal Knowles, understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Children’s files are complete.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KNOWLES FAMILY CHILD CARE
FACILITY NUMBER: 334843705
VISIT DATE: 10/16/2023
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· Staff’s files are NOT complete. A qualified assistant did not complete Part 2 of the CA child abuse mandated reporter training, however the general certificate is on file.
· A review of staff records on 10/11/2023 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at:http://www.ada.gov/childqanda.htm

Licensee Crystal Knowles, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA Susan Brewer, discussed the safe sleep regulations with licensee Crystal Knowles and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed licensee C. Knowles, of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KNOWLES FAMILY CHILD CARE
FACILITY NUMBER: 334843705
VISIT DATE: 10/16/2023
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A deficiency was issued on today’s date for a Type A violation.

LPA Susan Brewer informed licensee Crystal Knowles, that this report dated 10/16/2023 document(s) 102417(g) Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Susan Brewer, informed the licensee Crystal Knowles to provide a copy of this licensing report dated 10/16/2023 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.


No civil penalties issued on today’s date.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Crystal Knowles.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 10/16/2023 05:55 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501


FACILITY NAME: KNOWLES FAMILY CHILD CARE
FACILITY NUMBER: 334843705

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, the licensee did not comply with the section cited above in at 3:32 PM LPA S. Brewer, observed hygiene products and cleaning supplies in the children's restroom medicine cabinet and under the restroom vanity, and in the garage, which were not locked or latched. At 4:06 PM LPA observed items stored under the kitchen sink, such as Raid insect/bug killers and miscellaneous cleaning supplies, which were not locked and which poses a immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/17/2023
Plan of Correction
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The licensee agrees to make all poisons, detergents, cleaning compounds, medicines and or other dangerous/hazardous items inaccessible to children, by placing a combination or key lock on the garage door, the kitchen cabinet, the medicine cabinet and/or restroom lower cabinet to make inaccessible and submit proof of correction by photos though fax or e-mail on or before 10/17/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2023
LIC809 (FAS) - (06/04)
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