<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153807157
Report Date: 10/01/2021
Date Signed: 10/01/2021 09:33:50 AM

Document Has Been Signed on 10/01/2021 09:33 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:BAKER, KIMBERLY FAMILY CHILD CAREFACILITY NUMBER:
153807157
ADMINISTRATOR:BAKER, KIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 204-3110
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
10/01/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Kimberly BakerTIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/1/2021 Licensing Program Analyst (LPA) Caroline Harris conducted an unannounced case management inspection and met with Licensee, Kimberly Baker. A census was taken.

The purpose of this case management visit was to address the incident that took place on 1/12/2020, involving Mr. Baker having a shotgun and ammunition and the Kern County Sheriff's Office being called out to the home of the licensee. While reviewing facility records and past annual reports, there was no mention of the licensee stating that firearms were in the home. Neither the firearm/s or the incident on 1/12/2020 was previously reported to the Fresno Community Care Licensing office.

California Code of Regulations, Title 22, Division 12, Chapter 3, are being cited on the attached LIC 9099-D. "Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months."

A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 was given to the licensee.

An exit interview was conducted with licensee, Kimberly Baker. A copy of this report along with appeal rights was given to the licensee, Kimberly Baker. A Notice of Site Visit was also given to the licensee and must be posted for 30 days.
SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE: DATE: 10/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2021
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 3
Document Has Been Signed on 10/01/2021 09:33 AM - It Cannot Be Edited


Created By: Caroline Harris On 09/28/2021 at 11:52 AM
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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: BAKER, KIMBERLY FAMILY CHILD CARE
FACILITY NUMBER: 153807157

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/01/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/22/2021
Section Cited
CCR
102416.2(b)

1
2
3
4
5
6
7
The licensee shall report to the Department any of the events as specified in Health and Safety Code Section 1597.467(b)(1)(A)
through (b)(1)(C) that occur during the operation of the family child care home.
1
2
3
4
5
6
7
The licensee will complete on-line orientation and submit the completion certificate along with a statement that she understands what the reporting requirements are, by the due date of 10/22/21.
8
9
10
11
12
13
14
This requirement was not met as evidenced by the licensee failing to report an incident that occurred at her home on 1/12/2020, to the Fresno CCL office. This is a possible risk to the health, safety or personal rights of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Alice Juarez
LICENSING EVALUATOR NAME:Caroline Harris
LICENSING EVALUATOR SIGNATURE:
DATE: 10/01/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2021


LIC809 (FAS) - (06/04)
Page: 3 of 3
Document Has Been Signed on 10/01/2021 09:33 AM - It Cannot Be Edited


Created By: Caroline Harris On 09/28/2021 at 11:47 AM
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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: BAKER, KIMBERLY FAMILY CHILD CARE
FACILITY NUMBER: 153807157

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/01/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/01/2021
Section Cited
CCR
102417(g)(4)

1
2
3
4
5
6
7
Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger to children shall be stored where they are inaccessible to children.

1
2
3
4
5
6
7
All of the firearms were removed by the Kern County Sheriff's Office. The licensee stated that she understands that she must report any firearms to the Fresno CCL office and that they must be properly stored.
8
9
10
11
12
13
14
This requirement was not met as evidenced by information in a Kern County Sheriff's Office report dated 1/12/2020. This is an immediate risk to the health, safety or personal rights of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Alice Juarez
LICENSING EVALUATOR NAME:Caroline Harris
LICENSING EVALUATOR SIGNATURE:
DATE: 10/01/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2021


LIC809 (FAS) - (06/04)
Page: 2 of 3