525407536-2-14-2020-13-CC-CWIT-BLSVSX-20200214154213

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 525407536
Report Date: 02/14/2020
Date Signed: 02/14/2020 03:42:56 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:	GARCIA, JENNIFER FAMILY CHILD CARE HOME		FACILITY NUMBER:	525407536
ADMINISTRATOR:	GARCIA, JENNIFER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 355-1691
CITY:	RED BLUFF	STATE: CA	ZIP CODE:	96080
CAPACITY:	14	CENSUS: 9	DATE:	02/14/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Jennifer Garcia		TIME COMPLETED:	12:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	An annual inspection was made to the facility by Licensing Program Analyst (LPA), Wisehart. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently two adults living in the home. During today’s inspection the home and grounds were toured. The licensee and 2 aids were supervising 9 children, (3 infants/6 preschool age) and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The facility’s operating hours are 7 am to 6 pm, Mon–Fri. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the garage, Master bedroom and bathroom and Office, and they were made inaccessible by door knob covers. The home is clean, orderly and comfortable. There are safe toys and equipment available for children. The licensee stated there is a working telephone in the home. The licensee’s pediatric CPR and First Aid certifications were reviewed, and the First Aid expired on 11/18/19 and a class has been scheduled for March 19, 2020 and the Licensee's CPR expires on 12/12/21. Neither of the other two staff (S2/S3) present had a valid First Aid Card but they are also scheduled for the March 19, 2020 class. Items which could pose a danger to children (such as detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. Poisons are locked in a detached shed. The wood stove is not in use, however, the licensee understands that if used a fire screen would need to be installed first. The LPA observed a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020

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: GARCIA, JENNIFER FAMILY CHILD CARE HOME	FACILITY NUMBER: 525407536
	VISIT DATE: 02/14/2020

NARRATIVE

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The roster of children in care was reviewed and was current. The licensee has conducted an emergency drill within the past six months, last drill was documented on 6/23/19 and one is schedule for later this month. The licensee stated there are no firearms and/or other dangerous weapons in the home and none were observed during today's inspection. The children use the backyard as the outdoor play area and it is fully fenced. There were no pools or other bodies of water observed. Nine children's records were reviewed at 11:25 am current immunization's (except 2 infants (C5/C6)) and Notification of Parent’s Rights forms were on file. The licensee is providing Incidental Medical Services (IMS) to children in care. The Incidental Medical Services (IMS) policy was discussed with the licensee. 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 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, www.ada.gov/childqanda.htm. This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed and discussed with the licensee. The LPA provided the Shaken Baby Syndrome Flyer and the Lead Exposure Testing Flyer which were reviewed. The LPA also printed and reviewed the staff/ratio requirements. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: GARCIA, JENNIFER FAMILY CHILD CARE HOME	FACILITY NUMBER: 525407536
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/14/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/27/2020 Section Cited	1 2 3 4 5 6 7	Personnel Requirements102416(c)(1)(1). A current pediatric cardiopulmonary resuscitation card issued either by the American Red Cross or the American Heart Association, or by a training program that has been approved by the Emergency Medical Services Authority
	8 9 10 11 12 13 14	pursuant to Section 1797.191.1. This requirement was not met as evidenced by: Based on record review Staff (S1-S3) do not have a current First Aid card on file. Licensee's expired 11/18/19. This poses a potential risk to children in care.	8 9 10 11 12 13 14
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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: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2020

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020

LIC809 (FAS) - (06/04)

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