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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845906
Report Date: 07/07/2022
Date Signed: 07/07/2022 04:35:43 PM

Document Has Been Signed on 07/07/2022 04:35 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:REED FAMILY CHILD CAREFACILITY NUMBER:
364845906
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
07/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Ivy Reed, LicenseeTIME COMPLETED:
04:45 PM
NARRATIVE
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On 07/07/2022, Licensing Program Analysts (LPAs) Kay Turner and Rachel Zeron for another purpose. The facility was toured, a census was taken, and files were reviewed. During the tour, LPA Zeron observed 2 toddlers sleeping in a pack and play with bottles, blankets, shoes and pillows in with the children. In addition, the licensee was able to provide documentation of checking on the infants every 15 minutes. However, the sleep log failed to meet documentation as required by Title 22. This places the children at an immediate risk.

Please see LIC 809D for deficiencies.

Exit interview conducted and report was reviewed with the Licensee, Ivy Reed.



A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 07/07/2022 04:35 PM - It Cannot Be Edited


Created By: Karrene Turner On 07/07/2022 at 03:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: REED FAMILY CHILD CARE
FACILITY NUMBER: 364845906

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/08/2022
Section Cited
CCR
102425(b)

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Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement was not met as evidenced by:
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Licensee will ensure when the infants are placed to sleep, the area of sleep will be clear and free of all items.
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LPA observed the 2 of the toddler sleeping in the pack and play with blankets, bottles, pillows and shoes. This is an immediate risk to the Health, Safety & Personal Rights to the children in care.
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Type A
07/08/2022
Section Cited
CCR102425(j)(2A-D)

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Infant Safe Sleep
(2) The provider shall check and document the following:A) Labored breathing.(B) Signs of distress...(C)Infants up to 12 month of age who are sleeping in a position other than on their back...(D) Documentation shall be maintained in the infant’s file...




This requirement was not met as evidenced by:
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Licensee will create an infant log that meets the requirements of Title 22 regulations. Licensee will also submit a statement of understanding on how the facility will follow the regulation.
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Licensee was completing a 15 minute check but failed to meet the Title 22 requirements. This is an immediate risk to the Health, Safety & Personal Rights to the 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:Aaron Ross
LICENSING EVALUATOR NAME:Karrene Turner
LICENSING EVALUATOR SIGNATURE:
DATE: 07/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/07/2022


LIC809 (FAS) - (06/04)
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