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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422081
Report Date: 09/09/2026
Date Signed: 09/09/2026 03:46:11 PM

Document Has Been Signed on 09/09/2026 03:46 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:KISLING, CYNTHIAFACILITY NUMBER:
013422081
ADMINISTRATOR/
DIRECTOR:		KISLING, CYNTHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 927-0568
CITY:OAKLANDSTATE: CAZIP CODE:
94603
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
09/09/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:09 PM
MET WITH:Cynthia KislingTIME VISIT/
INSPECTION COMPLETED:
03:47 PM
NARRATIVE
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On 09/09/2026, Licensing Program Analyst (LPA) Nicole Reynoso arrived at the facility to conduct an UNANNOUNCED, Annual inspection at Cynthia Kisling's Family Childcare Home. LPA met with Licensee and explained the purpose of today's inspection. LPA was granted the inspection authority to enter the home. The home is a single story home. Present in the home at the time of inspection were Licensee, Licensee's two fingerprint cleared assistants and 8 children consisting of 2 infants and 2 preschoolers and 4 school aged children. The family childcare home days and hours of operation are Monday - Friday 7:00 AM to 5:30 PM.

ON-LIMIT areas: living room, dining room, hallway, bathroom, front yard. There is a wood-burning fireplace located in the living room but has not been in use and is blocked off and made inaccessible to children in care.

The ISOLATION AREA is the corner of the living room, away from other children in care.

OFF-LIMIT areas: backyard, bedrooms 1-3, laundry room, bathroom #2 (in daughters bedroom)

The off-limits areas are blocked off and made inaccessible to children in care.

LPA toured the front yard area. LPA observed the front yard to be completely fenced. There are ample toys and materials for children to play with inside and outside.

Continued on 809-C page 2----------------------------------------------

Monica Mathur
Nicole Reynoso
DATE: 09/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KISLING, CYNTHIA
FACILITY NUMBER: 013422081
VISIT DATE: 09/09/2026
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Page 2-------------------------------------------

Medicines, cleaning products, and sharp objects are stored inaccessible to children in care during today's inspection. The home maintains a working telephone. Licensee was reminded that smoking is not allowed in a family childcare home. Licensee states that there are 4 dogs in the home. Licensee stated there are no firearms or ammunition stored in the home. LPA did not observe any pools, hot tubs, spas or other bodies of water.

Food services were discussed with Licensee. Licensee states that they provide food for children. Licensee does not provide transportation services, however the licensee does walk to the nearby elementary school to walk the children to the family childcare home in the afternoons.

There is a 3A40BC fire extinguisher, working smoke and carbon monoxide detector located in the home. Children files and facility files were reviewed, and facility also contains a Children's Roster and Fire/Disaster Drill. The last fire and earthquake drill was conducted on 08/13/2026. Licensee is reminded to document all disaster drills, and they must be conducted every 6 months. Licensee's Mandated Reporter training expired 7/2025. Licensee and assistants will complete the mandated reporter training by 10/9/2026 and submit proof to LPA. Licensee's CPR/Pediatric First Aid Certification expires 04/2028 and one of the assistant's CPR/Pediatric First Aid training expires 10/2026. The home is sanitized and orderly in compliance with Title 22 Regulations during today's inspection, with heating and ventilation for the safety and comfort of children in care.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



continued on 809-C page 3----------------------------------------------------

NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Nicole Reynoso
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2026
LIC809 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KISLING, CYNTHIA
FACILITY NUMBER: 013422081
VISIT DATE: 09/09/2026
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. 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 (USDOJ) 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, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee Cynthia Kisling, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Cynthia Kisling

No deficiencies were observed during today's visit.

NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Nicole Reynoso
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2026
LIC809 (FAS) - (06/04)
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