525407624-10-11-2021-13-CC-CWIT-C7PT37-20211011142148

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 525407624
Report Date: 10/11/2021
Date Signed: 10/11/2021 02:21:53 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:	QUESADA, THOMASINA FAMILY CHILD CARE HOME		FACILITY NUMBER:	525407624
ADMINISTRATOR:	QUESADA, THOMASINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 364-1084
CITY:	RED BLUFF	STATE: CA	ZIP CODE:	96080
CAPACITY:	14	CENSUS: 1	DATE:	10/11/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Thomasina Quesada		TIME COMPLETED:	12:10 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	On 10/11/21 at 10:40 am, a annual inspection was made to the facility by Licensing Program Analyst (LPA), Wisehart. A review of staff records on 10/11/21 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 one adult living in the home. At 11:00 am the home was toured inside and outside. The licensee was supervising one child, and operating within the licensed capacity and ratio requirements. The facility provides 24/7 care, however, licensee understand she can't provide consecutive care. . The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are master bedroom/bathroom; bedroom #2 and Room #1 and laundry room per floor plan, and were made inaccessible via gates and door knob covers. Poisons are locked in backyard shed. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. The facility has no fire place. There is a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The licensee stated there are no firearms and/or other dangerous weapons in the home, and none were observed during today's inspection The home is clean, orderly and comfortable. There are safe toys and equipment available for children. There is a working telephone 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: 10/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021

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: QUESADA, THOMASINA FAMILY CHILD CARE HOME	FACILITY NUMBER: 525407624
	VISIT DATE: 10/11/2021

NARRATIVE

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Facility currently has no infants enrolled. There are cribs/play yards available for napping infants. Cribs have firm mattresses and are free of loose objects. Bedding is laundered weekly, and soiled bedding is stored inaccessible to children. Napping infants would be checked on every 15 minutes, and checks are documented.

The children use the back yard and it is fully fenced. The backyard needs mowing and licensee stated that until clean up is completed, the unfenced front yard will be used for outdoor play and 100% supervision will be provided. There were no pools or other bodies of water observed in the yard.

One child's records were reviewed at 11:10 am; required emergency information forms were observed to be on file. The licensee has completed Mandated Reporter training on 1/25/19 and will renew her certificate. The licensee and all employees have the required immunization's on file. The licensee has a pediatric CPR and First Aid certification which expired on 11/17/20 and due to COVID the licensee has not renewed but agreed to enroll in a new class .

This report was reviewed and discussed with the licensee. 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.

There were no Title 22 deficiencies cited during today's inspection though advisories were issued.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021

LIC809 (FAS) - (06/04)

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