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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455407761
Report Date: 06/14/2021
Date Signed: 06/16/2021 08:37:25 AM

Document Has Been Signed on 06/16/2021 08:37 AM - 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:CARBIN, KRIS FAMILY CHILD CARE HOMEFACILITY NUMBER:
455407761
ADMINISTRATOR:CARBIN, KRISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 710-7508
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 9DATE:
06/14/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Kris CarbinTIME COMPLETED:
11:30 AM
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An Annual inspection was made to the facility by Licensing Program Analyst (LPA), Snow and Mendez. A review of staff records on 6/14/21 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 and assistant were supervising nine 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 8:00 AM to 5:00 PM, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The home was clean and orderly, and was at a comfortable indoor temperature. There were 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 expires in 2022, Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) were stored out of the reach of children. Poisons are locked in a lock box. There is a working carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The said there were no weapons on none were observed.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2021
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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: CARBIN, KRIS FAMILY CHILD CARE HOME
FACILITY NUMBER: 455407761
VISIT DATE: 06/14/2021
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The children use the back yard is the outdoor play area and it is fully fenced, with gravel cushioning under play structure. There is also a nearby park that is utilized for play. There were no pools or other bodies of water observed in the yard.

Four children's records were reviewed at 11AM, required emergency information was observed to be on file. The licensee is not providing Incidental Medical Services (IMS) to children in care. The Incidental Medical Services (IMS) was discussed with the licensee. 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.


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 AAP 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. The LPA provided a copy of the Lead pamphlet & the new immunization form.

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.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2021
LIC809 (FAS) - (06/04)
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