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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585406301
Report Date: 05/30/2019
Date Signed: 05/30/2019 11:50:11 AM

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:HILL, PHYLLIS FAMILY CHILD CARE HOMEFACILITY NUMBER:
585406301
ADMINISTRATOR:HILL, PHYLLISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 205-6820
CITY:MARYSVILLESTATE: CAZIP CODE:
95901
CAPACITY:14CENSUS: 5DATE:
05/30/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Phyllis HillTIME COMPLETED:
12:00 PM
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On 05/30/19 an Annual/Random inspection was made to the facility by Licensing Program Analyst (LPA), David Wilson. Prior to this inspection a review of staff records on 05/22/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During today’s inspection the home and grounds were toured. The licensee was supervising five children, and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The facility’s operating hours are 7:00am to 6:00pm, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off limits areas were inaccessible, including a gate at the bottom of the stairs that lead up to the second story, a doorknob cover is on the door to the garage and an outdoor shed is in a gated portion of backyard and door kept locked while children in backyard. The home appeared clean, orderly and was at a comfortable indoor temperature. There are safe toys and equipment available for children. There is a working telephone in the home. The licensee has current pediatric CPR and First Aid certification, which expire on 03/08/2021. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. The licensee stated poisons are locked in the outdoor shed and in the garage. There is a working smoke detector, carbon monoxide detector and charged 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 children use the backyard as the outdoor play area and it is fully fenced. One section of the backyard has an area with outdoor shed that is off limits and the area to this outdoor shed is gated and door locked. There were no pools or other bodies of water observed in the yard. Two children's records were reviewed and contained Identification and Emergency Information (LIC700) was observed to be on file. The licensee is not 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 (See Evaluator Manual Regulation Interpretations and Procedures). 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 Academy of American 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.
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.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David WilsonTELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
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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