013422963-2-12-2020-52-CC-LIBO-BLQVUH-20200212154448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422963
Report Date: 02/12/2020
Date Signed: 02/12/2020 03:44:55 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:	MOUFARREJ, ANNE		FACILITY NUMBER:	013422963
ADMINISTRATOR:	MOUFARREJ, ANNE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 580-6577
CITY:	LIVERMORE	STATE: CA	ZIP CODE:	94550
CAPACITY:	14	CENSUS: 8	DATE:	02/12/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Anne Moufarrrej		TIME COMPLETED:	04:00 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	Licensing Program Analyst (LPA) Leslie Ibo arrived at the facility for an unannounced Annual/Random Inspection and met with licensee Anne Moufarrej. Present for this inspection was fingerprint cleared assistant Mariah Altizer, 4 infants, 4 preschool aged children. The licensee is in ratio today. Also residing at home are the licensee’s finger print cleared 2 children C. Moufarrej, husband Francois Moufarrej , 1 minor child F. Moufarrej. The home was toured with the licensee to conduct a health and safety inspection, there was an ongoing construction on the off limits of the licensee’s home . Hours of operation for day care are Monday through Thursday 7:00 am - 6:00pm & FRIDAYS 7:00 am- 5:30pm. ON LIMITS: newly constructed home extension which is located on the right side of the home, the extension has one bedroom, one bathroom, kitchen and family room, play area outside the extension room. OFF LIMITS: the entire former home. ISOLATION: living room (extension area of the home) The home is one story which consists of 4 bedrooms, 3 bathrooms, dining area, kitchen, dining area, family room, garage and fenced back yard. There were ample age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone, and first aid kit. ***Continued on LIC809-C…

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Leslie Ibo	TELEPHONE: (510) 622-2646
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

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: MOUFARREJ, ANNE	FACILITY NUMBER: 013422963
	VISIT DATE: 02/12/2020

NARRATIVE

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There is pool that is inaccessible for day care children, the pool also has its own fence. There is a fence dividing the play area of the kids going to the pool. Per licensee, there are firearms in the home that was inaccessible from children, located at the off limits area of the home. All required licensing documents are posted and visible for public review.

Children's files were reviewed found to be complete per licensing regulation. The facility roster was reviewed, and a copy obtained. The licensee's Pediatric CPR/First Aid certificate is current with an expiration date of 3/31/2020, licensee’s assistant has a current CPR/First Aid certificate with an expiration date of 9/26/2021. Licensee has current mandated reporter training that was done 9/4/2019, assistant has mandated reporter training that was completed 10/8/2018 and has a proof of required immunization's. Safe Sleep practices were discussed, and new car seat laws were provided. Licensee was advised to conduct and document fire and disaster drills for the new day care children at least once every six months. Licensee was reminded that exersaucers, baby walkers, bouncers, jumpers, and similar items are not allowed, and that smoking is prohibited in the home during day care hours. Licensee does not transports children. Licensee was reminded that children are never to be left in a parked vehicle.

A review of staff records indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearance or exemptions. Licensee was reminded that anyone working, residing or frequently visiting the home must be fingerprint cleared prior to being in the presence of children, or an immediate civil penalty can be assessed. Licensee is aware that any authorized employee of the Department may enter and inspect the home with or without advance notice.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

Individual Medical Services (IMS) policy was discussed. When any changes to the IMS plan is made, an updated 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.”

This report shall remain on file for 3 years. A Notice of Site visit was provided.

Exit interview conducted with licensee Anne Moufarrej . Copy of report and appeal rights provided.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Leslie Ibo	TELEPHONE: (510) 622-2646
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

LIC809 (FAS) - (06/04)

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