Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515407148
Report Date: 08/08/2018
Date Signed: 08/08/2018 02:40:33 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:CANTRELL, JENNIFER FAMILY CHILD CARE HOMEFACILITY NUMBER:
515407148
ADMINISTRATOR:CANTRELL, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 329-1092
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY:14CENSUS: 5DATE:
08/08/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Jennifer CantrellTIME COMPLETED:
02:50 PM
NARRATIVE
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An inspection was made to the facility by LPA Martinez. 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 4 adults living in the home. During today’s inspection the home and grounds were toured. The licensee was properly supervising children and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. Operating hours are 6:30 to 6:30, Mon–Fri. The floor plan was verified. The off-limits areas were inaccessible. The home appeared 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's pediatric CPR and First Aid expire 9/2018. 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 the shed outside. The fireplace is not operable. There is a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The licensee stated there are no firearms and/or other dangerous weapons in the home and none were observed during today's inspection. The children use the backyard as the outdoor play area and it is fully fenced. There were no bodies of water observed. Children's records were reviewed; required emergency information was on file. The licensee and her assistant did not have Mandated Reporter Certificates at this time. The licensee is not 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.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.
SUPERVISOR'S NAME: Erin McKayTELEPHONE: (530) 895-2660
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

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

DATE: 08/08/2018
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: CANTRELL, JENNIFER FAMILY CHILD CARE HOME
FACILITY NUMBER: 515407148
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/31/2018
Section Cited
HSC
1596.8662(b)(1)
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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. This requirement is not met as evidenced by: Based on record
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Licensee agrees to have herself and all adults who provide care and supervision complete the Mandated Reporter training by 8/31/18 and send in a copy to the department.
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review, the licensee failed to complete the mandated reporter training by 3/30/18 which poses a potential Health and Safety risk to the children 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 McKayTELEPHONE: (530) 895-2660
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

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

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