013423597-11-5-2020-02-CC-BNEN-BV3UL7-20201105144015

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423597
Report Date: 11/05/2020
Date Signed: 11/05/2020 02:40:45 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	DESERIO, IRIS		FACILITY NUMBER:	013423597
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	11/05/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Iris Deserio		TIME COMPLETED:	03:00 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	On 11/05/2020, Licensing Program Analyst (LPA) Brittany Newton made a scheduled tele-visit inspection via Zoom for the purpose of conducting a pre-licensing visit due to COVID-19 restrictions. LPA was met by the applicant, Iris Deserio. Present for the inspection was the applicant’s toddler aged daughter, and the applicant’s brother who was additionally present with his two toddler aged children. The applicant lives at the home with her daughter, husband, and father. LPA associated the family members over age 18 during the inspection to the facility. Purpose of Inspection: To determine if applicant meets the requirements to be issued a license to operate as a licensed Family Day Care facility. The home was inspected for safety, comfort, cleanliness, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. The home is a 2 story home, with the entire upstairs being off-limits. There is a gate blocking the entrance to the 2^nd floor. LPA reminded applicant that an area that is deemed off-limits, children shall not eat, sleep, or be in those areas. The home is fenced in and has 3 bedrooms, a kitchen, 2 baths, a bonus room and living room upstairs which are off-limits. The off limit areas are inaccessible by gate, closed and/or locked doors and visual supervision. Downstairs is completely dedicated to the family day care. Hours of Operation will be Monday through Friday 8:00AM until 5:00PM. The isolation area for ill children will be a corner of the living room or art area as needed downstairs. The applicant will be providing a morning and afternoon snack, lunch will be provided by parents of children. The bathroom for the children which is downstairs was found safe and no toxins or hazards present. Required documents and forms were found posted visibly near the entrance. There are ample age appropriate toys that appear to be safe and in good condition. The home has a centralized heater. There is a fully charged 2A10BC fire extinguisher on site. At 12:44PM the applicant tested the carbon monoxide detector which was working and operable. At 12:46PM the applicant tested the smoke detector which was working and operable. There are no pools, hot tubs or any other bodies of water. LPA did not observe any toxins or hazardous items accessible today. Outdoor play area was inspected. Outdoor play area has outdoor seating, woodchips/bark for cushioning the floor, and play structures for children. The backyard additionally has various plants and vegetables growing throughout. There are three locked sheds in the backyard that hold bikes, teaching materials, and other seasonal items.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Brittany Newton	TELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2020

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: DESERIO, IRIS	FACILITY NUMBER: 013423597
	VISIT DATE: 11/05/2020

NARRATIVE

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Iris Deserio stated that there are no guns or firearms in the home.

The applicant’s Health and Safety training is completed and CPR and First Aid certificate is current and expires 07/2022. Applicant has proof of immunization's and mandated reporter training.

LPA Newton went over record keeping for children’s files and discussed required forms. Also discussed was fire drill requirements, posting requirements, and incident reporting requirements. Applicant was able to ask questions and stated she understands the requirements for operating a family child-care home.

Incidental Medical Services (IMS) policy was discussed. 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 applicant was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet, and LPA discussed the importance of taking preventative measures.

Applicant 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. Applicant was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

APPROVAL OF LICENSE

LPA has determined that the applicant has met all of the requirements to receive a small Family Day Care license. Applicant has been granted a license to begin operating as a Family Day Care home. Facility license will be mailed to Licensee. Licensee may began operating, effective immediately.

Exit interview conducted, and a copy of this report was emailed to Iris Deserio. Her emailed response serves as a signature for this document.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Brittany Newton	TELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:	DATE: 11/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2020

LIC809 (FAS) - (06/04)

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