214005532-12-8-2020-05-CC-FBTQ-BW4MN5-20201208084456

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005532
Report Date: 12/03/2020
Date Signed: 12/08/2020 08:45:09 AM

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:	MUNOZ, MARCIA F.		FACILITY NUMBER:	214005532
ADMINISTRATOR:	MUNOZ, MARCIA F.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 879-2587
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY:	12	CENSUS: 0	DATE:	12/03/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Marcia F. Munoz		TIME COMPLETED:	01:00 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), Farhan Bashir-Tariq conducted a scheduled Pre-Licensing inspection for change of location today and met with Licensee, Marcia Munoz. This inspection was conducted via Face Time due to COVID-19. Purpose of the inspection was explained. There were no children present today. Licensee was previously residing at 189 Los Ranchitos Road, San Rafael, 94903 and License number for old home is 214005424. Old license will be closed upon approving this application. Licensee lives with husband and a child. LPA verified the background check clearance of adults working or living in the home. Licensee owns this single-family home, which has three bedrooms and one bathroom. Hours of operation will be: M-F, 7am–5pm. Licensee provides breakfast, lunch and two snacks. Daycare areas: Living area, Bedroom #2, Bathroom and Back yard. OFF limit areas: Bedroom #1, Bedroom #3, Kitchen, Garage, Closets and Front yard. LPA and Licensee inspected the entire home for health and safety hazards. All off limit areas were properly barricaded and made inaccessible to the children in care. Living area room will be used as main childcare area and front door will be used for children drop off and pickups. License and other required licensing documents will be posted by the front door. Home was observed to be clean and orderly with enough light and ventilation. Kitchen will be used only to prepare food and has been blocked off with a baby gate. Kitchen cabinets were secured with child safety locks and covers were installed on stove knobs. Chemicals or poisons are stored in a kitchen cabinet, which was inaccessible for children. Kitchen is not part of the licensed childcare area but will only be used to pass by. Bedroom #2 was approved to be used for childcare. Bedroom #2 will be used for napping and other children activities. Locks were observed on windows in Bedroom #2. Home has multiple combined smoke and carbon monoxide detectors. Licensee tested one of the detectors for this inspection. A working telephone, and a fully charged fire extinguisher of size 2A10BC or bigger were observed to be available in the home. First Aid Kit is fully stocked and accessible. All harmful and sharp objects are made inaccessible from children in care. License states that are no firearms or weapons present in home. Per Licensee, there are no bodies of water located anywhere in the home. Per Licensee, there are no pets in the home. Back yard including deck area was observed to be fully fenced all around and was approved to be used for childcare. Deck area leads to the grass part of back yard. Continuation on next page...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MUNOZ, MARCIA F.	FACILITY NUMBER: 214005532
	VISIT DATE: 12/03/2020

NARRATIVE

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Licensee was previously provided information and posters regarding COVID-19 and social distancing at her old place. Licensee confirmed that same protocol will be followed in the new home. LPA observed that posters were used at front door and in home to promote social distancing and to provide information about COVID-19 symptoms. A hand washing poster was observed to be posted in bathroom . Licensee was reminded to clean and disinfect day care areas thoroughly at least once a day. Sanitizers were also available at front door and in the home.

Licensee was reminded to conduct and log an emergency drill once every six months. Licensee has a current First Aid and CPR card expiring in April 2021. Licensee completed her Mandatory Child Abuse Training on 8/18/2020, which will be valid for two years. Licensee was reminded of NO walker, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible. Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website.

LPA reminded Licensee that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reminded Licensee , 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 encouraged Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates. This report is discussed and explained to Licensee . Records to be Maintain in the facility are explained. Mandatory Posting Requirements: License, Emergency Disaster Plan, and Notification of Parent's Rights Poster. Marin County Fire Department approved this home to accommodate capacity of 14 in accordance to fire safety regulations.

Large Family Child Care Home License is approved and will be effective as of today, 12/03/20.

This report will be kept in the facility file and will be made available for public review upon request. Desk duty is available M-F, 8AM-5PM at (650) 266-8800. Website for forms and Regulations: www.cdss.ca.gov

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

LIC809 (FAS) - (06/04)

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