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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418478
Report Date: 09/09/2019
Date Signed: 09/09/2019 09:51:22 AM

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:GALVAN, ALMAFACILITY NUMBER:
013418478
ADMINISTRATOR:GALVAN, ALMA RFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 728-5169
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY:14CENSUS: 4DATE:
09/09/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Alma GalvanTIME COMPLETED:
10:00 AM
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On 09/09/19, Licensing Program Analysts Briana Plumboy and Elimika Woods, met with licensee Alma Galvan for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was licensees fingerprint clear and associated son Kevin Galvan, fingerprint clear and associated assistant Cecilia Herrera, and 2 preschool age children. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:30am until 6:00pm.

The home is a single family home. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS consist of the living room, dining room, family room, master bedroom, master bathroom, hallway bathroom, garage/childcare room and back yard. Licensee is aware children may not eat or sleep in the garage/child care room. The OFF LIMIT AREAS consists of the kitchen and the remaining 2 bedrooms which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be family room. The BACKYARD play area is fenced. The wall heater is barricaded for children's safety. There are toys and learning equipment. There are no pools, hot tubs or any other bodies of water present in the on limits areas today. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible during today's inspection.

The home has a fully charged fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone, and First Aid Kit. The licensee CPR and First Aid certificate expired on 08/26/19, and she is currently enrolled in a CPR/First Aid course on 09/21/19. The licensee is in compliance with the immunization law. The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 05/18/19.
(4) Children files were reviewed, facility roster reviewed. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. See 809-C for continuance
See 809-C for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2019
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: GALVAN, ALMA
FACILITY NUMBER: 013418478
VISIT DATE: 09/09/2019
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Incidental Medical Services (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

LPA Plumboy provided a copy of Safe Sleep in Child Care brochure, a handout "What Does A Safe Sleep Environment Look Like?," and PIN 19-06-CCP to the licensee

The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility. Licensee was reminded of Departments inspection authority, with our without any notice.

Effective August 1, 2003 California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list



There are no deficiencies cited. 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: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2019
LIC809 (FAS) - (06/04)
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