525407784-12-2-2020-13-CC-KMAS-BVWUPQ-20201202144554

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 525407784
Report Date: 12/02/2020
Date Signed: 12/02/2020 02:46:50 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:	PHILLIPS, LAURA FAMILY CHILD CARE HOME		FACILITY NUMBER:	525407784
ADMINISTRATOR:	PHILLIPS, LAURA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 200-4539
CITY:	RED BLUFF	STATE: CA	ZIP CODE:	96080
CAPACITY:	14	CENSUS:	DATE:	12/02/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Applicant, Laura Phillips		TIME COMPLETED:	10:30 AM

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	A pre-licensing inspection was conducted on 12/02/2020 at 9:00am by Licensing Program Analyst (LPA), Kirk Marks. The facility inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak. The applicant is requesting a license for a capacity of 14. Services will be provided Monday through Friday; 4:00am to 5:30pm. The applicant understands that child care must be provided in the "primary" residence of the applicant. The residence is a four bedroom/two bath home. There are four adults living in the home. Applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. All minors residing in the home must be fingerprinted within 30 days of reaching their 18th birthday and obtain a TB clearance. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance. Two bedrooms and one bathroom are off limits to the children. These areas have been made inaccessible by means of door locks and a locking gate. The home appears to be clean and orderly at this time and will remain so during child care hours. There is a working telephone in the home. The sharp knives, cleaning supplies, and medicines are stored out of the reach of children. The poisons are locked in the detached garage. Firearms and ammunition were properly locked and stored in separate gun cabinets in the detached garage. The children in care will have access to age appropriate toys and equipment. The home is equipped with a working smoke detector, carbon monoxide detector and fire extinguisher rated at least 2A10BC. The children will use the back yard as the outdoor play area, and it is fully fenced. There is a trampoline located in the backyard. The licensee understands if the trampoline is used during day care hours, it must be according to the manufacturer's recommend usage (6 years and older), adult supervision (one adult when the trampoline is in use) and ensure that only one person uses the trampoline at a time.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk Marks	TELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2020

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: PHILLIPS, LAURA FAMILY CHILD CARE HOME	FACILITY NUMBER: 525407784
	VISIT DATE: 12/02/2020

NARRATIVE

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The additional adult does not include the licensee who must provide/ensure supervision to the remaining children. The licensee must comply with all the manufacturer's safety precautions/maintenance instructions and maintain the trampoline in good repair. There were was a hot tub observed in the yard and it was properly locked and inaccessible to children. Parents will be required to sign insurance affidavits if the provider does not plan to purchase additional child care liability insurance. Proof of control of property or landlord notification/consent is on file. Parent's rights will be posted. Emergency drills must be conducted at least once every six months and the date documented.
Children's records to be maintained were reviewed. The roster is to remain current at all times. Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report within seven days. The applicant will maintain current on Pediatric CPR and First Aid. The applicant shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current Pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged. Smoking is prohibited during the hours of operation in those areas where children are present.
The applicant understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website. http://ccld.ca.gov/ Megan's Law web site was provided (http://www.meganslaw.ca.gov). The licensee understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice. This report, as well as the American Association of Pediatrics Guide to Safe Sleep Practices brochure, were reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.
The facility will be processed for final licensing review.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk Marks	TELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2020

LIC809 (FAS) - (06/04)

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