197494225-6-19-2019-30-CC-JCHR-BDANNU-20190619103720

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494225
Report Date: 06/19/2019
Date Signed: 06/19/2019 10:37:33 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	LEIVA FAMILY CHILD CARE		FACILITY NUMBER:	197494225
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS:	DATE:	06/19/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:16 AM
MET WITH:	Applicant		TIME COMPLETED:	10:47 AM

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 06/19/2019 an announced pre-licensing inspection was conducted by Licensing Program Analyst (LPA) Jillinda Chandler. LPA Chandler met with applicant, who guided analyst on a tour of the home. All areas identified on the facility sketch were inspected. This is a single family, two story home with 5 rooms and 2 bathrooms. The two bedrooms and 1 bathroom located in the upper part of the home will be off limits. LPA observed gated stair cases leading to the upper area. Located in the upper level of the home and inaccessible to day care children was the families living quarters which consist of the: kitchen, living room, two bedrooms, laundry room and one restroom. The lower level of the home shall be used for day care purposes; this area consists of an office (Rm.1) a class room (Rm. 2 on the right) and an infant room (Rm. 3 on the left) and a restroom designated to child care. Families shall enter the home using the lower level entry door. The home has an attached garage which will be off limits, the door shall remain locked at all times. Family members residing at facility are: applicant, applicants spouse and their two minor children. Applicant was reminded that all children under the age of ten years shall be included in capacity during day care areas. Day care hours are Monday -Friday; 6:30 A.M. - 6:30 P.M. The home was inspected inside and out for safety, comfort, telephone service, heating/ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Based on todays inspection theses standards were met. The first aid kit was observed, and contained the necessary medical items: tweezers, scissors, thermometer and bandages. Per applicant, there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons. There is no pool, spa or other bodies of water on the premises. There are age appropriate toys and equipment on the premises. The smoke and carbon monoxide detectors are in operable condition. A standard 2A10BC fire extinguisher was observed. Applicant has provided proof of Preventative Health and Safety. CPR & First Aid expires 2/2021. Applicant has submitted an emergency disaster plan and demonstrated control of property at the above address by presenting transfer of trust deed..

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LEIVA FAMILY CHILD CARE	FACILITY NUMBER: 197494225
	VISIT DATE: 06/19/2019

NARRATIVE

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Children will use the lower area of the back yard for out doors activity; no toys or cushioning was observed in this area. The upper yard shall remain of limits at this time. Shall applicant decide to utilize upper area, LPA shall be contacted to review recommended corrections and a new facility sketch shall be submitted.

The following regulations were discussed:
· Licensee was made aware that state law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category. Licensee was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family child care home during the hours of operation.
· .Applicant was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and to never shake a baby to prevent the Shaken Baby Syndrome.
· Applicant was also reminded that only children eating may be in high chairs and that car seats are utilized only for transportation.
· The "Notification of Parent's Rights" (PUB394) was discussed with the licensee and the licensee was advised that it must be posted in an area of the home accessible to parents.
· Licensee was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541; Email Address: childcareadvocatesprogram@dss.ca.gov
· Also, discussed was; Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. Exemption were also discussed
· Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com. applicant has met this standard.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LEIVA FAMILY CHILD CARE	FACILITY NUMBER: 197494225
	VISIT DATE: 06/19/2019

NARRATIVE

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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

A copy of Exposure to Lead poisoning was provided.

Based on todays inspection the home shall be recommended for licensing following correction of suggested recommendations ( see advisory notes)

The inspection was concluded and a copy of this report was provided to applicant.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019

LIC809 (FAS) - (06/04)

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