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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418053
Report Date: 08/12/2022
Date Signed: 08/12/2022 09:28:45 AM


Document Has Been Signed on 08/12/2022 09:28 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:ANDREWS, JULIE & CHARLESFACILITY NUMBER:
013418053
ADMINISTRATOR:ANDREWS, JULIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 245-9620
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY:14CENSUS: 7DATE:
08/12/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Julie AndrewsTIME COMPLETED:
09:40 AM
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On August 8, 2022 at approximately 8:10 am, Licensing Program Analyst (LPA) Simerjit Kaur arrived at the facility to conduct case management inspection. LPA met with licensee Julie Andrews. Upon arrival there were 2 preschool children. Present during the inspection, licensee's assistant Sarah Wilson and 1 infant age child, 1 school age child, 3 preschool age children arrived. Also residing in the home is licensee’s finger print cleared husband Charles Andrews. Hours of operation for child care are Monday through Friday, 7:00am to 5:00pm. The facility is a one story house.

Licensee requested to add the 2 bedrooms and a office for naps to on-limits area. LPA conducted a health and safety inspection of the 2 bedrooms and a office. The following was observed during today’s inspection:


ON LIMIT AREAS (accessible to children in care): Kitchen, living room, dining room, play room on right of hallway, hallway bathroom, office, 1 bedroom located adjacent to office, 1 bedroom located adjacent to master bedroom, backyard. LPA observed the facility to be clean and in good repair, with heating and ventilation for safety and comfort. There are ample age appropriate toys that are observed to be safe and in good condition. The backyard has a fence surrounding the perimeter of the yard. LPA did not observe any dangerous conditions, nor any hazardous or toxic items accessible to children in the ON Limit areas of the facility today.

OFF LIMIT AREAS (not accessible to children in care): Master bedroom/bathroom, garage, both sides yard. OFF Limit areas are inaccessible by closed and/or locked doors and visual supervision. Licensee is advised to contact Licensing Department so that an inspection can be completed prior to changing an OFF Limit area to ON Limit.
Licensee and assistant have current First Aid/CPR and current Mandated Reporter Training Certificate. The home has a fully charged 4A60BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. Per licensee, there are no firearms in the home. LPA discussed safe sleep regulation. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Simerjit KaurTELEPHONE: (510) 622-2632
LICENSING EVALUATOR SIGNATURE:
DATE: 08/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2022
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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