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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005289
Report Date: 08/11/2020
Date Signed: 08/11/2020 06:05:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BLUNCK-RIBEIRO, ISABELLAFACILITY NUMBER:
214005289
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
08/11/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Isabella Blunck-RibeiroTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA), Farhan Bashir-Tariq conducted a scheduled case management inspection for capacity increase on 8/11/20 with Licensee, Isabella Blunck-Ribeiro. This inspection was conducted via face time due to COVID-19. Purpose of the inspection was explained. There was only one child present today with Licensee. All adults living or working in the home have fingerprints clearance on file. Hours of operation are: M-F, 7:30 AM – 5:30 PM. Licensee provides breakfast, lunch and two snacks.

LPA and Licensee inspected the entire day care area for Health and Safety hazards. LPA observed that off limit areas were properly barricaded and made inaccessible to the children in care. There were multiple carbon monoxide detectors and smoke detectors available in the home. Licensee performed the tests to check the functionality of the detectors. A Fire Extinguisher of size 2A10BC or bigger and a working telephone was also available in the home. First Aid kit is fully stocked and accessible. Per Licensee, there are no firearms or weapons in the home. Licensee states, there are no bodies of water in the home. Licensee has a dog in the home, which is kept on off limit area during day care hours. Children also use front yard to play .LPA observed front yard is fully fenced all around. There were plenty of toys, books and other learning materials available. All posting requirements are met.

Licensee has current and valid CPR and First Aid card expiring in June 2021. LPA reviewed facility's fire drill log and Per Log, last drill was conducted on May 10, 2021. Licensee is aware of the requirement of conducting and logging fire drills once every six months. LPA informed Licensee that all children and adults file shall be kept updated at all times. During the visit, LPA also provided information and assistance about issues related to COVID-19. Licensee was reminded to clean and disinfect the home thoroughly at least once a day. LPA reminded Licensee that As of January 1, 2018, all staff is required to complete Mandated Child Abuse Reporter Training (AB1207) every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed training completion certificates for Licensee dated 5/8/19. This training is valid for two years. LPA encouraged Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Facility can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

Large Family Child Care Home License will be approved upon receiving fire clearance from San Rafael Fire Department.


This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Licensee was advised for any additional questions to call Office, M-F, 8AM-5PM at 650-266-8800. For Rules and Regulations, visit the Website:
www.cdss.ca.govcre areas thoroughly at least once a day.

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-TariqTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2020
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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