255407802-1-8-2021-13-CC-BMEZ-BX435A-20210108165624

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 255407802
Report Date: 01/08/2021
Date Signed: 01/08/2021 04:57:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	BOULADE, AIMEE FAMILY CHILD CARE HOME		FACILITY NUMBER:	255407802
ADMINISTRATOR:	BOULADE, AIMEE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 640-0737
CITY:	ALTURAS	STATE: CA	ZIP CODE:	96101
CAPACITY:	14	CENSUS: 0	DATE:	01/08/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Aimme Boulade		TIME COMPLETED:	03:12 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	A pre-licensing tele-inspection was conducted today by LPA Mendez and Martinez by Facetime. The applicant is requesting a license for a capacity of 14. Services will be provided Mon-Fri 7:30am-5:30pm. The residence is a three bedroom/ two bath home. There is one adult and one minor living in the home at the time of this visit. The applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. All minors residing in the home must be fingerprinted within 30 days of reaching their 18th birthday and obtain a TB clearance. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance. Children will have access to the entire home except a master bedroom, laundry room that leads to outer area. The restroom will be used for childcare use. The children will enter the home through the front door of the house. Poisons are stored in the key locked closet..The sharp knives, cleaning supplies, medicines, are stored out of the reach of children. There is a heating monitor in the home that was made inaccessible by a gate in the living room.The children in care will have access to age appropriate toys and equipment. The children will use the yard that is fully fenced as outdoor play there is a barrier protecting the fence that prevents children from climbing under. There are farm animals on the premises that are inaccessible to children, they are fenced in. The applicant understands that any animal food/water bowl will need to be out of reach of children during day-care hours. The home is equipped with a working smoke detector and carbon monoxide detector fire extinguisher rated at least 2A10BC was observed in the home. The licensee stated that there are no firearms in the home. The applicant may intend to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Bianca Mendez	TELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2021

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: BOULADE, AIMEE FAMILY CHILD CARE HOME	FACILITY NUMBER: 255407802
	VISIT DATE: 01/08/2021

NARRATIVE

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The applicant may obtain liability insurance and will provide the department with a copy of the insurance once decided. Parent's rights poster will be posted. Emergency drills must be conducted at least once every six months and the date documented. Children's records to be maintained were reviewed. The roster is to remain current at all times. Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report within seven days. The applicant will remain current on Pediatric CPR and First Aid. The applicant shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current Pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged. Smoking is prohibited at all times in those areas where childcare is provided.

The applicant understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website. http://ccld.ca.gov/. Megan's Law web site was provided (http://www.meganslaw.ca.gov). The licensee understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice. This report was reviewed and discussed with the applicant. Guide to Safe Sleeping Practices pamphlet was provided and discussed.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

The following items need to be sent to the office before being licensed
1. Updated fire clearance from fire marshal
2. Confirmation that PHP course has been signed up for
3. Photos of the posted items for parents
4. Photos of door knob covers for door knobs preventing access from hallway to laundry room
5. Covers for the trash in kitchen area that is accessible to children
6. Photo of the kitchen area condensed/cleared to prevent anything from falling on a child.
7. Photos of living room, play area, dining room, kitchen and bedroom 1 and 2 that is accessible to children.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Bianca Mendez	TELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2021

LIC809 (FAS) - (06/04)

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