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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585407952
Report Date: 09/10/2021
Date Signed: 09/10/2021 10:39:41 AM

Document Has Been Signed on 09/10/2021 10:39 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:WALTERMIRE, DESTINY FAMILY CHILD CARE HOMEFACILITY NUMBER:
585407952
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
09/10/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Applicant, Destiny WaltermireTIME COMPLETED:
10:45 AM
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A pre-licensing inspection was conducted by Licensing Program Analyst (LPA) Kirk Marks. The applicant is requesting licensing for a small family child care home with capacity not to exceed 8. Operational hours are 7:00 AM to 5:00 PM, Monday - Friday. The residence is a two story, four bedroom/three bath home, with an attached garage. There are two adults living in the home, applicant is caregiver background check cleared. Applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with Community Care Licensing Department. 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 civil penalty for adults working or residing in the home without a criminal record clearance. The accessible areas of the home are the living room, dining room, kitchen, playroom (bedroom) and one bathroom. The areas in the home that are off-limits are the garage and the entire upstairs which contains three bedrooms, two bathrooms and laundry room. These areas have been made inaccessible with safety door locks and locking gate to the stairway. The back yard will be the primary outdoor play area and it is fully fenced, free of debris, and safe for children. There are no bodies of water in the back yard. The home was 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 are stored out of reach of children on counter top . Cleaning supplies are stored in a locked cabinet. Medications are stored in a high cabinet in the bathroom. All poisons are locked in a cabinet in the garage. The home has a fireplace that is not in use and has been secured. The applicant stated there are no firearms/weapons on the premises and none were observed during today's inspection.

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SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Kirk Marks
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2021
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: WALTERMIRE, DESTINY FAMILY CHILD CARE HOME
FACILITY NUMBER: 585407952
VISIT DATE: 09/10/2021
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The children in care will have access to age appropriate toys and equipment. The home is equipped with at least one working smoke detector, carbon monoxide detector and a charged fire extinguisher. Licensee will not be carrying liability insurance for the children.
Parents' rights will be posted. Emergency drills must be conducted at least once every six months and the date must be documented. The applicant shall be present in the home and shall ensure that children in care are supervised by a finger-printed adult with current Pediatric CPR and First Aid certification. Applicant has completed pediatric CPR/ First aid, which expire on 3/23/2023. The applicant has not completed Mandated Reporter Training at the time of inspection. The applicant understood 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 understood 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. When caring for over 6 children, one of the children in care and must be school-aged and one must be at least 6 years of age. Smoking is prohibited in the home at all times and in outdoor areas where children are present. Incidental Medical Services (IMS) will not be provided and 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 (USDOJ) 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, available at: http://www.ada.gov/childqanda.htm. Safe sleep practices were discussed with the applicant. The applicant understood the responsibility to read and have knowledge of the laws and regulations for the 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 at http://www.meganslaw.ca.gov. The licensee understood that any authorized employee of the Department may enter and inspect the facility with or without advance notice. This report was reviewed and discussed with the applicant. 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.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Kirk Marks
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
LIC809 (FAS) - (06/04)
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