Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455406573
Report Date: 08/28/2018
Date Signed: 08/28/2018 03:47:52 PM

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:SISCO, CRYSTAL FAMILY CHILD CARE HOMEFACILITY NUMBER:
455406573
ADMINISTRATOR:SISCO, CRYSTALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 710-5004
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:14CENSUS: 13DATE:
08/28/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Crystal SiscoTIME COMPLETED:
03:50 PM
NARRATIVE
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An inspection was conducted at the facility by Licensing Program Analysts (LPA) Kirk Marks and Patricia Pacheco. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are presently 2 adults living in the home. During today’s inspection the home and grounds were toured. The licensee and her assistant were properly supervising 13 children and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. Operating hours are 5:30 am to 5:30 pm, Monday–Friday. The floor plan was verified. The off-limits areas include the garage which was made inaccessible by means of a doorknob cover and the kitchen, den, bedrooms and side yards which were all made inaccessible by means of gates/fences. The home was clean and orderly and maintained at a comfortable indoor temperature. There is a working telephone in the home. The licensee did not have evidence of current pediatric CPR and First Aid certifications for herself. 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 cabinet in the garage. The licensee stated that the fireplace in the living room is not used. The wood stove that is used is located in the off-limits den. There is a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The licensee has a current roster of children in care and conducted an emergency drill on 08/23/18. The licensee's firearms and ammunition were stored appropriately. The children use the backyard as the outdoor play area and it is fully fenced. There were no bodies of water observed. The licensee stated that neither she nor her assistant have completed the required Mandated Reporter Training. The licensee is not currently providing Incidental Medical Services – IMS. Incidental Medical Services (IMS) policy was discussed. 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 following violation of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.
Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Patricia PachecoTELEPHONE: 530-895-5886
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2018
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: SISCO, CRYSTAL FAMILY CHILD CARE HOME
FACILITY NUMBER: 455406573
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/07/2018
Section Cited
CCR
102416(c)
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Personnel Requirements. The Licensee and other personnel as specified shall complete training on preventive health practices including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
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Licensee will submit proof of enrollment in CPR/First Aid class by 09/07/18, and submit proof of completion of course by 10/07/18.
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This requirement has not been met as evidenced by the licensee not being able to present evidence of current pediatric CPR and First Aid certifications. This poses a potential health and safety risk to children in care.
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Type B
09/28/2018
Section Cited
HSC
1596.8662
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Mandated Reporter Training. On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child 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
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The licensee agreed to have the licensee's assistant complete AB 1207 Mandated Reporter Training and send evidence of completion to CCLD by 9/28/18.
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which he or she completed the initial mandated reporter training. This requirement has not been met as evidenced by the licensee stating she and her assistant have not yet taken the course. This poses a potential health and safety risk to children in care.
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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: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Patricia PachecoTELEPHONE: 530-895-5886
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2018
LIC809 (FAS) - (06/04)
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