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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585408057
Report Date: 03/07/2022
Date Signed: 03/07/2022 02:43:11 PM

Document Has Been Signed on 03/07/2022 02:43 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:JONES, KAYLA FAMILY CHILD CARE HOMEFACILITY NUMBER:
585408057
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
03/07/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Applicant/Licensee, Kayla JonesTIME COMPLETED:
03:00 PM
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A prelicensing inspection was conducted today at 1:30am by Licensing Program Analyst (LPA), Kirk Marks. LPA met with applicant/licensee Kayla Jones. The applicant is requesting a change of location license for a capacity of 8. The facility will operate Monday-Friday, 7:00am to 5:00pm. The residence is a 4 bedroom/2 1/2 bath two story home. There are two adults and five 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: Entire upstairs which includes all four bedrooms and two bathrooms, as well as the garage downstairs. These areas have been made inaccessible by means of locking child gate and a door lock. Poisons are locked in the garage. The home is equipped with a working smoke detector and fire extinguisher rated at least 2A10BC. The licensee stated the gas insert fireplace will not be utilized during child care hours and the power switch has been disabled. The children will use the backyard as the outdoor play area. The backyard is completely fenced. There is no pool, spa, pond, fountain, or any other body of water on the premises.

LPA reviewed with applicant 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.

Applicant 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.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Kirk Marks
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2022
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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