483010321-10-25-2024-01-CC-MAUN-DADQ2W-20241025114750

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 483010321
Report Date: 10/25/2024
Date Signed: 10/25/2024 11:47:57 AM

Document Has Been Signed on 10/25/2024 11:47 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME:	KELLY, BRIDGET FCCH		FACILITY NUMBER:	483010321
ADMINISTRATOR/ DIRECTOR:	KELLY, BRIDGET		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 477-4850
CITY:	VACAVILLE	STATE: CA	ZIP CODE:	95687
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 17	CENSUS: 11	DATE:	10/25/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:05 AM
MET WITH:	Bridget Kelly - Licensee		TIME VISIT/ INSPECTION COMPLETED:	12:00 PM

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An Annual/Required inspection was made to the facility by Licensing Program Analyst (LPA), Melchisedeck Augustin. A review of staff records on 10/25/2024 indicates all facility staff or other individuals who require caregiver background checks received a criminal record and child abuse index clearances or exemptions. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. According to the Licensee, the facility was not registered with the Resource and Referral Agency's, Food Program. The facility currently did not have any active/standing waivers.

During today’s inspection, the home and grounds were toured. The floor plan submitted by the licensees was reviewed and verified. Licensee (LS) and two staff (S1 & S2) were supervising eleven children and the facility was operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The off-limits areas of the home are the entire second floor, kitchen, living room, and garage, and were made inaccessible by means of a children’s safety gates. The fireplace in the living room was screened. The staircase was indirectly barricaded via means of a safety gate installed in the hallway between the bathroom and kitchen area. The children have access to two bedrooms, one bathroom, and backyard. The facility’s operating hours are 7:00am to 5:00pm, Mon–Fri.

The home was at a comfortable indoor temperature. There were safe toys available for children. (Continue to LIC 809-C)

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: KELLY, BRIDGET FCCH	FACILITY NUMBER: 483010321
	VISIT DATE: 10/25/2024

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There is a working telephone in the home and the Licensee understood that the facility telephone was required to stay at the facility during operating hours. Licensee's Pediatric Cardiopulmonary Resuscitation (CPR) and First Aid certification expire on 03/26/26. LPA did not observe any poison(s). LPA verified that ammunition and firearm(s) were locked and stored separately. There is a functional smoke and carbon monoxide detectors, and a fully charged fire extinguisher that met the standards of the state fire marshal. LPA did not observe any bodies of water.

According to the facility's disaster drill log, an emergency disaster drill was conducted within six months, and the log reflected a drill was conducted on 10/04/24. The facility roster of the children in care was reviewed and appeared to be complete. LPA reviewed five children’s records at 10:26am which contained Consent for Emergency Medical Treatment (LIC 627), Identification and Emergency Information (LIC 700), Parents Rights (LIC 995A), and Immunization Records (IR). Licensee confirmed she currently had three child(ren) over 12 months but under 24 months old enrolled in care, and according to LS, the infants took a nap on cots.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensees of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

On this date, 10/25/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. (Continue to LIC 809-C)

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024

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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: KELLY, BRIDGET FCCH	FACILITY NUMBER: 483010321
	VISIT DATE: 10/25/2024

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Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with the Licensee, Bridget Kelly. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. There were no violations of California Code of Regulation(s), Title 22; Division 12, observed during today’s visit.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024

LIC809 (FAS) - (06/04)

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