525407784-11-8-2021-13-CC-CWIT-C8KUAD-20211108142432

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 525407784
Report Date: 11/08/2021
Date Signed: 11/08/2021 02:24:38 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 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: 5	DATE:	11/08/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Laura Phillips		TIME COMPLETED:	01:10 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 11/8/2021, at 11:05 am, an annual inspection was made to the facility by Licensing Program Analyst (LPA), Wisehart A review of staff records on 11/8/2021 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 four adults living in the home. At 11:15 am the home was toured inside and outside. The licensee and aid were supervising 5 children, and operating within the licensed capacity and ratio requirements. The facility’s operating hours are 6 am - 5:30 pm, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are three bedrooms and one bathroom, and were made inaccessible by door locks and gates. . Poisons are locked in a detached garage. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the home. The licensee stated firearms and ammunition are properly locked and stored in separate gun cabinets in the detached garage. The home is clean, orderly and comfortable. There are safe toys and equipment available for children. There is a working telephone in the home. 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 infants. Napping infants are checked on every 15 minutes, and checks will be documented on a sleep log. No infants were observed to be swaddled, and infants under 12 months are placed on their backs for sleeping.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie Wisehart	TELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2021

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: PHILLIPS FAMILY CHILD CARE HOME	FACILITY NUMBER: 525407784
	VISIT DATE: 11/08/2021

NARRATIVE

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The children use the fenced front porch and front yard as the outdoor play area and they are 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. 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 was a hot tub observed in the back yard and it was properly locked and inaccessible to children. The LPA printed and reviewed the Individual Infant Sleep Plan (LIC 9227) and the Safe Sleep regulations and the LPA provided COVID guidance.

Two children's records were reviewed at 11:52 am; required emergency information forms were observed to be on file. Individual Sleeping Plans were printed for licensee and she will keep them on file for infants under 12 months of age. The licensee has completed Mandated Reporter training (expires 8/25/22). The licensee and all employees have the required immunization's on file. The licensee has current pediatric CPR and First Aid certification, which expire on 12/10/22.

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: 11/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2021

LIC809 (FAS) - (06/04)

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