<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525407763
Report Date: 08/09/2021
Date Signed: 08/09/2021 12:47:10 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 08/09/2021 12:47 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:PALMER, KRISTI FAMILY CHILD CARE HOMEFACILITY NUMBER:
525407763
ADMINISTRATOR:PALMER, KRISTIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 966-4807
CITY:REDBLUFFSTATE: CAZIP CODE:
96080
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 10DATE:
08/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Michelle McNealTIME COMPLETED:
11:20 AM
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 8/9/21 at 9:10 am , a annual inspection was made to the facility by Licensing Program Analyst (LPA), Wisehart. A review of staff records on 8/9/21 indicates that facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions other then Staff (S1) who was not associated to the facility which was reviewed on 7/13/20 during pre-licensing visit. There are currently two adults living in the home.

The home was toured inside and outside. The Staff #1 was supervising 10 children in the day care room and Staff #2 was in the home and they were not operating within the licensed capacity and ratio requirements because Staff #1 was not fingerprinted associated to the facility. The facility’s operating hours are 7:30 am - 4:30 pm , Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are all areas but day care room and were made inaccessible by gates. Poisons are locked in shop. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. The wood stove is in living room which is inaccessible via a gate. There is a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The licensee stated their are firearms in the home and they are locked and ammo is stored separately. The home,is clean, orderly and comfortable. Stairs are barricaded with gate. There are safe toys and equipment available for children. There is a working telephone in the home.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2021
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 3
Document Has Been Signed on 08/16/2021 08:39 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 08/10/2021 07:40 AM


Created By: Carrie Wisehart On 08/09/2021 at 10:24 AM
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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: PALMER, KRISTI FAMILY CHILD CARE HOME
FACILITY NUMBER: 525407763

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/10/2021
Section Cited
CCR
102416.5(c)

1
2
3
4
5
6
7
For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:
(1) Twelve children, no more than four of whom may be infants; or
(2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met.
1
2
3
4
5
6
7
Licensee agrees to stay within Title 22 staff child ratio's. Licensee to send in plan to CCL on how ratio's will be met by 8/10/21.
8
9
10
11
12
13
14
 (1) Twelve children, no more than four of whom may be infants; or
(2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met. Based on observation, the licensee did not comply with the section cited above as Staff #1 was observed alone with 10 children upon LPA entry. This poses an immediate health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Type A
08/10/2021
Section Cited
CCR102416(d)(3)

1
2
3
4
5
6
7
Prior to employment or initial presence in the child care home, all employees and volunteers subject to a criminal record review shall:
(3) Request and be approved for a transfer of a criminal record exemption, as specified in Section 102370.1(p), unless, upon request for a transfer, the
1
2
3
4
5
6
7
Licensee will send in plan that staff and volunteers subject to criminal record review will be fingerprinted and associated to facility prior to being present in the facility by 8/10/21.
A Civil Penalty was assessed for $100.
8
9
10
11
12
13
14
Department permits the individual to be employed, reside or be present at the facility. Based on observation and record review, the licensee did not comply with the section cited above as Staff #1 was observed alone with 10 children upon LPA entry and did not have fingerprints associated to facility. This poses an immediate health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
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:Megan Aviles
LICENSING EVALUATOR NAME:Carrie Wisehart
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2021


LIC809 (FAS) - (06/04)
Page: 2 of 3
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: PALMER, KRISTI FAMILY CHILD CARE HOME
FACILITY NUMBER: 525407763
VISIT DATE: 08/09/2021
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
26
27
28
29
30
31
32
There are cribs/play yards available for napping infants. Cribs have firm mattresses and are free of loose objects. Bedding is laundered weekly, and soiled bedding is stored inaccessible to infants. Napping infants are checked on every 15 minutes, and checks will be documented on a safe sleep log. No infants were observed to be swaddled, and infants under 12 months are placed on their backs for sleeping.

The children use the back yard as the outdoor play area and it is fully fenced. There were no pools or other bodies of water observed in the yard.

The children's records were reviewed at 10:17 am; required emergency information forms were observed to be on file. The licensee has completed Mandated Reporter training will be enrolling to renew expired certificate (6/10/21). The licensee and all employees have the required immunization's on file. The licensee has current pediatric CPR and First Aid certification, which expire on 1/22.

This report was reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3