013421059-6-10-2021-52-CC-BPLY-C3URET-20210610125803

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421059
Report Date: 06/10/2021
Date Signed: 06/10/2021 12:58:11 PM

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:	BUCHANAN, VICTORIA		FACILITY NUMBER:	013421059
ADMINISTRATOR:	BUCHANAN, VICTORIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 581-8983
CITY:	CASTRO VALLEY	STATE: CA	ZIP CODE:	94546
CAPACITY:	14	CENSUS: 8	DATE:	06/10/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Victoria Buchanan- Licensee		TIME COMPLETED:	01:10 PM

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 6/10/21, Licensing Program Analyst Briana Plumboy, met with licensee Victoria Buchanan for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was fingerprint clear assistants Nicholas Buchanan, Nataliya Perminova and 8 preschool age children. The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday through Friday from 8:00am until 6:00pm. The home is two stories. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are all located on the first level of the home. They are the living room, bedroom, family room, dining room, and bathroom. The OFF LIMIT AREAS are the kitchen, laundry room, garage, and entire second story of the home which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be the living room. The SIDEYARD play area is completely fenced with rubber playground tiles for padding. There is an anchored play structure in the yard. The stairs inside the home are fenced to prevent access to children under the age of 5 years old. There are toys and learning equipment. There are no pools, hot tubs or any other bodies of water present in the on limit areas during the time of the inspection. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone, and First Aid Kit. The licensee CPR and First Aid certificate is current and expires 05/24/21. The licensee's mandated reporter training is complete and she received a certification of completion on 06/25/20, Nicholas received his certificate on 6/25/20, and Nataliya received her certificate on 06/03/21. Both licensee and her assistants whom are present today have the required immunization's. The fireplace is screened and locked with a child safety latch 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 05/14/21. Facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. See 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: BUCHANAN, VICTORIA	FACILITY NUMBER: 013421059
	VISIT DATE: 06/10/2021

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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

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.

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 Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021

LIC809 (FAS) - (06/04)

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