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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911686
Report Date: 12/15/2021
Date Signed: 12/15/2021 01:34:02 PM

Document Has Been Signed on 12/15/2021 01:34 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:BRILEY, CRYSTAL FAMILY CHILD CAREFACILITY NUMBER:
153911686
ADMINISTRATOR:BRILEY, CRYSTALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 709-3853
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
12/15/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Crystal BrileyTIME COMPLETED:
01:45 PM
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Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On December 15, 2021, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Crystal Briley for a pre-licensing/change of regional office location inspection. Applicant, her Fiance, two adult daughters and two minor children reside in the home. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance. Fire clearance was granted on December 1, 2021.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • Fire clearance was received on December 6, 2021. Fire alarm is located on the home’s living room (day care room) wall.
  • This is a single story, four bedroom and two bathrooms home and children will have access to the living room (day care room), family room, dining room, kitchen and hallway bathroom. Off-limits rooms are made inaccessible by use of plastic door knob covers and child proof safety gates.
  • There is a fireplace in the family room that applicant states it will not be used during day-care hours.
  • LPA observed children size furniture, safe toys, and books for the children. There is a flat screen mounted onto the living room wall. Children will nap in the day care room on cots. Infants will nap in play yards. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2021
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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: BRILEY, CRYSTAL FAMILY CHILD CARE
FACILITY NUMBER: 153911686
VISIT DATE: 12/15/2021
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Provisional License for a Large Family Day Care Home capacity of 14 children ages under 18 years will be issued for 90 days, pending receipt of the Preventive Health and Safety Training certification and Mandated Reporter Certification for applicant's assistant. Provisional license will be effective December 16, 2021.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: BRILEY, CRYSTAL FAMILY CHILD CARE
FACILITY NUMBER: 153911686
VISIT DATE: 12/15/2021
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  • Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
  • Applicant’s Pediatric CPR and First Aid certification was completed through American Red Cross Emergency Medical Services Authority stickers (EMSA) and expires on February 18, 2023.
  • Knives are stored inside the knife block on top of the refrigerator, other knives are stored in a cup that is located inside a top kitchen cabinet. Medications are stored inside a top kitchen cabinet. Cleaning compounds are stored inside the cabinet that is located underneath the kitchen sink and made inaccessible by the use of a child proof magnetic lock.
  • Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
  • Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
  • There is an in-ground pool that is fenced with a white rod iron fence in accordance with Title 22 Regulations. The gate is self-latching/self-closing, swings away from the pool and latching device is located no more than six inches from the top of the gate.
  • There is a dog that is kept on the gated side run of the home and will be inaccessible to the day care children. There are three cats that are kept indoors/ outdoors and will be accessible to the day care children. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
  • Applicant states there are no firearms or ammunition in the home or premises. Poisons are kept locked.
  • Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
  • Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
  • Applicant states she will not be transporting day care children. Applicant understands that she must have proper car seat restraints and/or car seats for all the children under her care when transporting children.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: BRILEY, CRYSTAL FAMILY CHILD CARE
FACILITY NUMBER: 153911686
VISIT DATE: 12/15/2021
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  • Fenced backyard has a cemented and sodded area for the day care children. There is a patio porch for shade and patio furniture. LPA observed in the backyard lawn; three Little Tikes slide play structures, a Little Tikes play house. Also observed two scooters a Step 2 picnic bench and other safe toys.
  • SB 792 immunizations verified and on file.
  • Applicant completed the Mandated Reporter Training on June 11, 2021. Applicant’s Assistant, Hannah Briley's Mandated Reporter Training expired. The required training can be found at www.ccld.ca.gov or www.mandatedreporterca.com.
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
  • Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. She is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday from 7:30 AM to 5:30 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.


(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
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