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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585407866
Report Date: 04/30/2021
Date Signed: 05/03/2021 03:41:23 PM

Document Has Been Signed on 05/03/2021 03:41 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:EASTER, TRACY FAMILY CHILD CARE HOMEFACILITY NUMBER:
585407866
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
04/30/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Tracy EasterTIME COMPLETED:
04:00 PM
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A pre-licensing inspection was conducted on 4/30/2021 at 3:00pm by Licensing Program Analyst (LPA), Kirk Marks. The facility inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak.
The applicant is requesting a change of location license for a capacity of 8. Services will be provided Monday through Friday 7:00am to 5:30pm. The applicant understands that child care must be provided in the "primary" residence of the applicant. The residence is a three bedroom/two bath home. There are three adults living in the home. Applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. All minors residing in the home must be fingerprinted within 30 days of reaching their 18th birthday and obtain a TB clearance. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance.
Two bedrooms, laundry room and one bathroom are off limits to the children. These areas have been made inaccessible by means of safety door locks. The home appears to be clean and orderly at this time and will remain so during child care hours. There is a working telephone in the home. The sharp knives, cleaning supplies, and medicines are stored out of the reach of children. Poisons are not kept at 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 in care will have access to age appropriate toys and equipment. The home is equipped with a working smoke detector, carbon monoxide detector and fire extinguisher rated at least 2A10BC. The children will 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.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Kirk Marks
LICENSING EVALUATOR SIGNATURE: DATE: 04/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2021
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: EASTER, TRACY FAMILY CHILD CARE HOME
FACILITY NUMBER: 585407866
VISIT DATE: 04/30/2021
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Parents will be required to sign insurance affidavits if the provider does not plan to purchase additional child care liability insurance. Proof of control of property is on file. Parent's rights are posted. Emergency drills must be conducted at least once every six months and the date documented. Children's records to be maintained were reviewed. The roster is to remain current at all times. Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report within seven days. The applicant will maintain current on Pediatric CPR and First Aid. The applicant shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current Pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged. Smoking is prohibited during the hours of operation in those areas where children are present.

The applicant understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website. http://ccld.ca.gov/
Megan's Law web site was provided (http://www.meganslaw.ca.gov). The licensee understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice. This report, as well as the American Association of Pediatrics 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.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

The facility will be processed for final licensing review.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Kirk Marks
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2021
LIC809 (FAS) - (06/04)
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