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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334843952
Report Date: 04/29/2019
Date Signed: 04/29/2019 10:57:12 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:REYNOLDS FAMILY CHILD CAREFACILITY NUMBER:
334843952
ADMINISTRATOR:REYNOLDS, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 880-4972
CITY:LA QUINTASTATE: CAZIP CODE:
92253
CAPACITY:14CENSUS: 11DATE:
04/29/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:11 AM
MET WITH:Jennifer ReynoldsTIME COMPLETED:
11:10 AM
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(3) On date and time listed, Licensing Program Analysts (LPAs) Ana Noble and Giselle Carbullido arrived at the facility to conduct an annual inspection. LPA toured the facility, inside and out, records were reviewed and the following was observed and/or discussed: Licensee was present with 11 children and 2 assistants.
Normal days and hours of operation are: Monday-Friday 6:30 am - 5:00 pm
OFF-LIMIT AREAS INCLUDE: Entire upstairs level, master bedroom-downstairs, garage and backyard
· The licensee is present in the home and ensures that children in care are supervised at all times
· The licensee is operating within the licensed capacity and ratios
· Fire extinguishers, smoke detectors, and carbon monoxide detectors meet State Fire Marshall standards and were tested by the applicant during this inspection.
· Fireplaces and open face heaters are screened to prevent access by children
· Where children less than five years old are in care, stairs are fenced or barricaded
· Storage areas for poisons, detergents, cleaning compounds, medications and other items which could pose a danger to children are stored where they are inaccessible to children
· All poisons are locked
· Storage areas for firearms and other dangerous weapons are inaccessible to children, and locked
· Ammunition is stored and locked separately from weapon(s) LICENSEE UNDERSTANDS ALL GUNS, WEAPONS AND AMMUNITION MUST BE KEY-LOCKED SEPARATELY AND MADE INACCESSIBLE PER TITLE 22 REGULATIONS.
· The home is kept clean and orderly, with heating and ventilation for safety and comfort
· Each child has safe, healthful, and comfortable accommodations, furnishings, and equipment
· The home provides safe toys, play equipment, and materials
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2019
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 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: REYNOLDS FAMILY CHILD CARE
FACILITY NUMBER: 334843952
VISIT DATE: 04/29/2019
NARRATIVE
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· All pools, spas, hot tubs, fish ponds, or similar bodies of water are made inaccessible to children by covering or fencing as specified by regulation. LICENSEE 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 when not in use.
· The home has a current roster of children
· The home conducts fire and disaster drills at least once every six months, and documents the date and time of each drill
· Licensee documents immunizations and maintains and updates records for children in care
· Licensee provides the child's parent or representative with a copy of the Family Child Care Home Notification of Parents' Rights
· The licensee and other personnel, as specified, have completed training on preventive health practices which was completed; including pediatric CPR and First Aid which expires 5/2020.
· The licensee was asked to provide information in regard to having an association to any licensed community care facility. The licensee states she is not associated to any other licensed facility.
· Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed. Resident and/or staff records reviewed on 4/26/19 indicate that all adults who require caregiver background checks have received all required clearances or exemptions.
· The licensee understands that upon notice of the Department to remove an individual from the home, pursuant to H&S Code 1596.871(c)(2), or to exclude an individual from the home, pursuant to H&S Code 1596.8897, the licensee immediately removes the individual and prevents them from returning to the home or having contact with children in care
· Children are not left in parked vehicles and the licensee understands that this is prohibited
· The licensee understands that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2019
LIC809 (FAS) - (06/04)
Page: 2 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: REYNOLDS FAMILY CHILD CARE
FACILITY NUMBER: 334843952
VISIT DATE: 04/29/2019
NARRATIVE
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As a REMINDER: when your child(ren) turn 18 years of age, you MUST SUBMIT an updated LIC279, LIC508 and TB Screen and have your child submit for LIVESCAN background clearance. This also applies to any adult PRIOR to them moving into the home or who currently lives in the home. Also, PRIOR to employment of any adult, you must submit the LIC508, TB screening and obtain a background clearance through LIVESCAN.

A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS.

A copy of this report was provided to Ms. Reynolds, Licensee on this date and must be made available to the public upon request for the next 3 years.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2019
LIC809 (FAS) - (06/04)
Page: 5 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: REYNOLDS FAMILY CHILD CARE
FACILITY NUMBER: 334843952
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/14/2019
Section Cited
HSC
1597.622
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Health and Safety Code: SB 792 – Effective September 1, 2016, a person may not be employed or volunteer at a child care center or a family child care home unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption (Health and Safety Code sections 1596.7995). This requirement was not met
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Licensee agrees to submit proof of Measles and Pertussis for Licensee and Staff #1 to the Department by 5/14/2019.
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by evidence of: Licensee and Staff #2 did not have proof of pertussis and measles as required in SB792. This poses a potential risk to the Health and Safety of children.
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Type B
05/14/2019
Section Cited
HSC
1596.8662(B)(1)
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AB1207. On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter traingin every two
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Licensee agrees to submit proof of completed training of mandated reporter for herself and two assistants to Department by 5/14/2019.

http://mandatedreporterca.com/
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years. This requirements was not met by evidence by: Licensee and both assistants did not have certificate of completion of required mandated reporter training. This is a potential risk to children if not completed.
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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) 248-0228
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2019
LIC809 (FAS) - (06/04)
Page: 6 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: REYNOLDS FAMILY CHILD CARE
FACILITY NUMBER: 334843952
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/14/2019
Section Cited
CCR
102421(b)
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Child's Records The licensee shall maintain, in each child's record, a copy of the emergency information card required in Section 102417(g)(7).This requirement was not met by evidence of Child #3 did not have Identification and Emergency Information, LIC700 in file during inspection. This is a potential risk for child.
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Licensee agrees to obtain a completed Identification and Emergency Information Form, LIC700 for Child #3 and submit to the Dept. by 5/14/2019.
Type B
05/14/2019
Section Cited
CCR
102416(a)
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Personnel Requirements. The licensee shall provide each employee with a copy of the Notice of Employee Rights (LIC 9052 (4/88)) form furnished by the Department. This requirement was not met by evidence of: Both assistants did no have Notice of Employee Rights, Form LIC9052 in file during visit. This is a potential risk for children
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Licensee agrees to provided both assistants with Notice of Employee Rights, Form LIC9052. Submit to the Dept. by 5/14/2019
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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) 248-0228
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2019
LIC809 (FAS) - (06/04)
Page: 7 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: REYNOLDS FAMILY CHILD CARE
FACILITY NUMBER: 334843952
VISIT DATE: 04/29/2019
NARRATIVE
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· Facility is not currently providing IMS Incidental Medical Services (IMS) policy was discussed. 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
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

The following was reviewed with the licensee(s):
- AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For a Zero Tolerance violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Zero Tolerance violation the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
- Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2019
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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: REYNOLDS FAMILY CHILD CARE
FACILITY NUMBER: 334843952
VISIT DATE: 04/29/2019
NARRATIVE
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- Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility’s phone numbers must be on file at all times.
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The applicant is urged to visit the U.S. Consumer Product Safety Commission webpage at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled
- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.
- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov.
- Please subscribe at childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov
vPlease completed Mandated Reporter Training at the following link: http://mandatedreporterca.com/

- The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

See LIC809D for cited deficiencies. Appeal rights discussed and a copy of this report was provided to the licensee on this date.

During the exit interview, the LICENSEE, Jennifer Reynolds, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2019
LIC809 (FAS) - (06/04)
Page: 4 of 7