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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700301
Report Date: 11/02/2021
Date Signed: 11/02/2021 06:00:27 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:SCHIRLE, ROBINFACILITY NUMBER:
015700301
ADMINISTRATOR:SCHIRLE, ROBINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 644-9223
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY:14CENSUS: 2DATE:
11/02/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
06:30 PM
MET WITH:Robin SchirleTIME COMPLETED:
07:30 PM
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On 11/01/2021, Licensing Program Analyst (LPA) Jaylena Miller conducted a Pre licensing Inspection. LPA met with licensee Robin Schirle for an announced change of location Inspection. The licensee plans to operate Monday-Friday from 7:00am-6:00pm for infants to school age children. LPA conducted a health and safety inspection inside and outside with licensee.

The home is a two story home with 4 bedrooms including a master bedroom with bathroom and one bedroom downstairs, 2 bathrooms including one downstairs that will be used for children in care, a family room, living room, a garage, a kitchen with dining area and back yard which is completely fenced in.

The OFF LIMITS areas are the entire upstairs area and the garage and will be inaccessible to children by locked doors, safety gates and visual supervision.

The ON LIMITS are are the family room, living room, kitchen with dining area, downstairs bedroom, and bathroom. The backyard will be used as the outdoor play area and LPA observed age appropriate toys and furnishings in working condition.

The home is neat and clean with central heating and ventilation for safety and comfort. All hazardous materials and toxins are kept out of reach from children and would be inaccessible to children during daycare hours. The home has a working smoke detector, carbon monoxide detector, fully charged fire extinguisher size 2A-10-BC, and first aid kit. Per licensee, there are no firearms on the premises.

The Licensee has received certificates of completion in Health and Safety on 03/16/2019, lead poison prevention training on 10/13/2021, the mandated reporter training on 10/15/2021 and CPR/First Aid is current and expires on 06/19/2023. LPA Miller discussed with licensee the CPR/First Aid and Mandated Reporter Training must be renewed every two years and CPR/First Aid needs to be EMSA approved.

LPA reminded licensee a roster of the children must be properly maintained, and the fire/disaster drills every six months must be documented.

LPA Miller is granting a provisional large family child care home license as of 11/2/2021 pending an approved fire clearance.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jaylena MillerTELEPHONE: (510) 292-8297
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021
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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