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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 325408154
Report Date: 07/13/2022
Date Signed: 07/13/2022 12:25:32 PM

Document Has Been Signed on 07/13/2022 12:25 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:HERMO, KRISTEN FAMILY CHILD CARE HOMEFACILITY NUMBER:
325408154
ADMINISTRATOR:HERMO, KRISTENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 375-0151
CITY:CHESTERSTATE: CAZIP CODE:
96020
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
07/13/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Kristen HermonTIME COMPLETED:
10:10 AM
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A pre licensing inspection was conducted today at 8:55 am by Licensing Program Analyst (LPA), Wisehart. LPA met with applicant Kristen Hermo. The applicant is requesting a license for a capacity of 14. The facility will operate Monday-Friday, 8:00 am to 5:00 pm. The residence is a 4 bedroom/2.5 bath two story home. There stairs have gates both at the top and bottom of the stair. There are 2 adults and 3 minors currently living in the home.

The home and yard were toured, and the facility sketch was verified. The following areas will be off limits to children: upstairs which have gates at the top and bottom and the garage which will have a lock added to it. Poisons will be locked in the garage. The home is equipped with a working smoke detector and fire extinguisher rated at least 2A10BC. The fireplace is securely screened with a fire fence. The children will use the backyard as the outdoor play area. The backyard is completely fenced. The yard has a trampoline with a net and licensee will use according to manufactures directions. There is an above ground pool on the property which is fenced by an black 5 ft rod iron pool fence with an unobstructed view with a gate that opens away from the pool and self closes which meets title 22 regulations.

LPA reviewed with applicant representative the LIC 311D, Forms/Records To Keep In Your Family Child Care Home, children’s forms/records, facility forms/records, and information to be posted.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022
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: HERMO, KRISTEN FAMILY CHILD CARE HOME
FACILITY NUMBER: 325408154
VISIT DATE: 07/13/2022
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Applicant representative was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 platform.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the applicant, Kristen Hermo.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
LIC809 (FAS) - (06/04)
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