013421857-1-22-2024-52-CC-MPRE-CZQUEG-20240122143107

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421857
Report Date: 01/22/2024
Date Signed: 01/22/2024 02:31:14 PM

Document Has Been Signed on 01/22/2024 02:31 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	QUIHUIS, GEORGIANNA		FACILITY NUMBER:	013421857
ADMINISTRATOR:	QUIHUIS, GEORGIANNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 750-1932
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94542
CAPACITY:	14	CENSUS: 8	DATE:	01/22/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Georgianna Quihuis		TIME COMPLETED:	02:30 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 1/22/2024 at 12:35pm Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Georgianna Quihuis for a Required – 3 Year Inspection. Present during the inspection was the Licensee and five (5) preschool age children. Two (2) more preschool age children and one (1) school age child arrived a few minutes later along with Licensee's adult Daughter. Licensee lives in the home with her adult daughter who serves as her helper, Nicole Quihuis, and Licensee’s three grandchildren ages fourteen (14), thirteen (13) and eleven (11). The facility operates 7:00am – 6:00pm, Monday – Friday. ON LIMITS AREA: Living Room, Playroom, Kitchen (for eating only), Bathroom across from the kitchen and Backyard OFF LIMITS AREA: Three (3) bedrooms, Hallway Bathroom and Garage ISOLATION AREA: Living Room or Playroom The facility is single story home rented by the Licensee. The inside of the home is observed to be neat, clean with ample age-appropriate materials for the children. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. Licensee stated that she provides all food for the children that is properly maintained and stored. All food that is brought from the children’s home will be properly labeled and stored. All children’s bedding was observed to be clean and properly stored. All off limit areas are made inaccessible with locks, gates, and closed doors. Licensee stated they transport children from the neighboring schools. Licensee stated there are no firearms and one (1) dog in the home. Page 1 of 4

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024

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: QUIHUIS, GEORGIANNA	FACILITY NUMBER: 013421857
	VISIT DATE: 01/22/2024

NARRATIVE

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The home has one (1) fully charged 3A40BC fire extinguisher in the kitchen. There is one (1) working smoke detector in the playroom and another across from the kitchen. There is a carbon monoxide detector across from the kitchen as well. The home is equipped with many windows and portable fans for proper ventilation and space heaters for heat. All fans and heaters are placed in inaccessible areas, so they are no danger to the children in care. The fireplace in the living room is blocked by furniture and made inaccessible to children in care. The wall heater in the living room is fully enclosed with a wooden barricade and turned off.

The backyard of the home is fully fenced, clean, properly maintained with ample age-appropriate materials for the children. There is a shed that is locked and inaccessible to the children in care. LPA did not observe any harmful bodies of water in or around the home.

The facility is operating within its licensed capacity and is in ratio. Licensee’s Health and Safety training has been completed and EMSA approved Pediatric CPR & First Aid has been completed and expires 6/2024. Licensee’s Mandated Reporter training is complete and expires 7/22/2025. Fire/disaster drills have been conducted and recorded with the last drill logged 1/4/2024. All required forms are posted in the playroom. All adults living and working in the home have obtained a criminal record clearance, exemption, or transfer. LPA obtained the children’s files and facility files. All files were complete.

No deficiencies cited during LPA’s inspection.

Licensee was reminded that California law requires Licensees to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, Licensee’s must submit the Unusual Incident/Injury form (LIC 624B) to the Department. Licensee was reminded that any structural changes or additions to the home must be reported to Community Care Licensing. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting https://mandatedreporterca.com/. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov Page 2 of 4

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: QUIHUIS, GEORGIANNA	FACILITY NUMBER: 013421857
	VISIT DATE: 01/22/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, Licensee Georgianna Quihuis, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: QUIHUIS, GEORGIANNA	FACILITY NUMBER: 013421857
	VISIT DATE: 01/22/2024

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Georgianna Quihuis.

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SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024

LIC809 (FAS) - (06/04)

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