334844363-6-19-2024-09-CC-SBRR-D6DUQT-20240619154740

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334844363
Report Date: 06/19/2024
Date Signed: 06/19/2024 03:47:52 PM

Document Has Been Signed on 06/19/2024 03:47 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	KIRKLAND FAMILY CHILD CARE		FACILITY NUMBER:	334844363
ADMINISTRATOR/ DIRECTOR:	ALICIA KIRKLAND		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(951) 809-2224
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92501
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	06/19/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:27 PM
MET WITH:	Alicia Kirkland, Licensee		TIME VISIT/ INSPECTION COMPLETED:	04:00 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 the above date and time Licensing Program Analysts (LPAs) Susan Brewer and Aman Lama, arrived at the facility to conduct an annual inspection. LPA was greeted by Licensee Alicia Kirkland, and granted entry to tour the facility inside and out. LPA reviewed records and observed and/or discussed the following: No other persons or staff present on today’s date. Per licensee, a qualified staff is scheduled from 8:00 AM to 12:00 PM. The licensee agrees to submit an updated LIC610A Emergency Disaster Plan by 07/19/2024. Normal days and hours of operation: Monday - Friday, 5:00am - 6:00pm OFF-LIMIT AREAS INCLUDE: Master Bedroom, Detached Garage and dog run. The inspection consisted of reviews of the following domain: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio and Capacity, Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. The facility is operating within the licensed capacity and appropriate ratios. LPAs took a census of 5 children in care. · The Licensee is present in the home and has ensured that children in care are supervised. · When temporarily absent from the home, Licensee shall arrange for a substitute adult to care for and supervise children. · A working telephone is present. · A fully charged fire extinguisher (2A:10BC) was observed and tagged by the fire department and needle in the green. A smoke detector and carbon monoxide detector were present and tested by the licensee during this inspection. · All hazardous items are not inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children.

SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KIRKLAND FAMILY CHILD CARE	FACILITY NUMBER: 334844363
	VISIT DATE: 06/19/2024

NARRATIVE

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· Storage of poisons are inaccessible to children and are locked.
· This is a single-story home and no stairs indoors. There are stairs on the front and back entries.
· The fireplace is properly screened on 06/19/2024.
· No guns or weapons present as stated by the Licensee. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations.
· Home is clean and orderly, with heating and ventilation for safety and comfort.
· Clean, Safe and age-appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced and/ or appropriate supervision is present.
· Verification of control of property on file by rental agreement. On file.
· Property owner/landlord notification and consent are on file.
· Pediatric CPR and First Aid training is on file for licensee completed:11/11/2023 Card expired on:11/11/2025
· Health & Safety Certificate - completed on 01/14/2017
· Mandated reporter General: 04/25/2022; AB 1207 Child Care Expired: 04/25/2024-SEE LIC809D
· Fire clearance was granted on: 03/10/2022
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 05/15/2024 at 3:30 PM, 5 children and lasted 10 minutes.
· There are no bodies of water 06/19/2024. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Children’s files are not complete where on infant in care is missing the LIC9227 Individual Sleeping Plan.
· Staff’s files are complete on today's date.

A review of staff records on 06/19/2024 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The licensee requested to remove individuals on their Guardian facility roster on 06/19/2024.

SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KIRKLAND FAMILY CHILD CARE	FACILITY NUMBER: 334844363
	VISIT DATE: 06/19/2024

NARRATIVE

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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.

For IMS information see Evaluator Manual - Regulation Interpretations and Procedures see Provider Information Notification (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: http://www.ada.gov/childqanda.htm

Licensee Alicia Kirkland, was reminded that all adults 18 and over living or working in the home, 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 Susan Brewer, discussed the safe sleep regulations with licensee Alicia Kirkland 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 licensee Alicia Kirkland, 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov.

SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KIRKLAND FAMILY CHILD CARE	FACILITY NUMBER: 334844363
	VISIT DATE: 06/19/2024

NARRATIVE

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For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A deficiency was issued on today’s date for 2 Type B violations.

No civil penalties issued on today’s date.

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

Exit interview conducted and report was reviewed with the licensee Alicia Kirkland.

SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/19/2024 03:47 PM - It Cannot Be Edited

Created By: Susan Brewer On 06/19/2024 at 03:24 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KIRKLAND FAMILY CHILD CARE	FACILITY NUMBER: 334844363
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/19/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in the licensee did not renew the mandated reporter training as required every two years following the date on which they completed the initial mandated reporter training, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/19/2024
	Plan of Correction
1 2 3 4	The licensee agrees to ensure the licensed child day care provider and employees, complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training and submit proof of their renewal training certificate on or before 07/19/2024.

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in one infant under 12 months of age, present in care, did not have the LIC9227 on file, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/24/2024
	Plan of Correction
1 2 3 4	The licensee agrees to ensure Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. In addition, the licensee agrees to submit a completed LIC9227 form to the department for a subject infant child under 12 months of age, enrolled at the facility on or before 06/24/2024.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Ana Noble

LICENSING EVALUATOR NAME:

Susan Brewer

LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

LIC809 (FAS) - (06/04)

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