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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455407622
Report Date: 10/28/2021
Date Signed: 10/29/2021 02:22:28 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:AQUINO FAMILY CHILD CARE HOMEFACILITY NUMBER:
455407622
ADMINISTRATOR:AQUINO, RAQUELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 567-5460
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:14CENSUS: 7DATE:
10/28/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Raquel Aquino TIME COMPLETED:
05:00 PM
NARRATIVE
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On 10,28/21 at 12:25pm, an inspection was made to the facility by Licensing Program Analyst. At 12:30 the home was toured inside and outside. The licensee and assistant were supervising 7 children (including 4 infants) and operating within the licensed capacity and ratio requirements. The facility’s operating hours are 8am-5pm Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The children use the back yard as the outdoor play area and it fully fenced. The pool is fully fenced with 5ft mesh pool fencing & a self latching, self closing gate that is approved. 4 children's records were reviewed at 1:30pm 2 staff records were reviewed at 2pm.
The following observations resulted in deficiencies that were cited (see LIC 809D): At 12:30 LPA observed 3 infants (C1, C2, C3) behind closed doors for nap time. C1 was observed in the play yard with a with a pacifier that had an 11" string with loose beads hanging. C2 was in the same room and was awake in a stroller. In a second room C3 was also sleeping in a stroller. Both doors were closed. The licensee did not know about sleep regulations, did not have any sleep records for infants C1, C2, C3 or C4. C4 is under 12 months and did not have the required Individual Infant Sleeping Plan (LIC227). The Licensee stated that she was not aware of the sleep regulations.
The Licensee 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 discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: AQUINO FAMILY CHILD CARE HOME
FACILITY NUMBER: 455407622
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102352(p)(2)
Definitions
(2)"Play Yard" means a framed enclosure with integrated mesh or fabric sides that has not been banned or recalled by the United States Consumer Product Safety Commission.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation at 12:30pm infants C2&C3 were put to sleep in strollers. The licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/31/2021
Plan of Correction
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Send a statement detailing approved sleep equipment.
Type A
Section Cited
CCR
102425(b)(1)(A)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects. (1) Pacifiers shall be allowed in the crib or play yard if the following provisions are in place: (A) There shall not be anything attached to the pacifier.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation at 12:30pm infant C1 was asleep with a pacifier that had an 11" string with loose beads hanging which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/28/2021
Plan of Correction
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A statement of understanding that nothing loose is to be in with a sleeping infant. The Licensee agrees not to use pacifiers with anything attached.
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: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:
DATE: 10/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2021
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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: AQUINO FAMILY CHILD CARE HOME
FACILITY NUMBER: 455407622
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(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 observation the garage containing poisons (paint etc was unlocked. The cabinet in the laundry containing many cleaning products and some poisons (carpet cleaner, bug killer) was unlocked & accessible. The licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/28/2021
Plan of Correction
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Licensee locked during visit. The Licensee will send a plan to ensure poisons shall remain locked.
Type B
Section Cited
CCR
102417(g)(5)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation of excessive standing water in the back yard. Toys holding at least 8 " of standing water that has been there for 3 days of care per the licensee who said the children have not been outside in 3 days so she didn't empty the standing water. The licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/31/2021
Plan of Correction
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The Licensee emptied the water and shall send a statement of understanding that children shall not have access to bodies of water.
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: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:
DATE: 10/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2021
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: AQUINO FAMILY CHILD CARE HOME
FACILITY NUMBER: 455407622
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview the Licensee said she was not aware of the Sleep Regulations and was not tracking every 15 minutes of sleep for infants C1-C4 & does not have rollover documentation on C4 who is an infant 12 months. C1-C3 were observed sleeping behind a closed door. Did not comply with the section cited above in fall 4 infants in care today which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/28/2021
Plan of Correction
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The licensee shall review PIN # PIN 20-24-CCP (Safe Sleep Regulations) prior to accepting children for care tomorrow. Also review & PIN 19-02-CCP & PIN 19-16-CCP. The Licensee shall address the deficiencies above in writing and present a plan to stay in compliance including signing up for automatic regulation updates.
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: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:
DATE: 10/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/28/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: AQUINO FAMILY CHILD CARE HOME
FACILITY NUMBER: 455407622
VISIT DATE: 10/28/2021
NARRATIVE
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https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

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

Exit interview conducted and report was reviewed with the licensee, R. Aquino.

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.

Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file. Notice of Site Visit shall be posted for 30 days from today’s visit.
A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5