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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283003772
Report Date: 02/10/2020
Date Signed: 02/10/2020 04:29:03 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:BROWN, MARIA & CORY FCCHFACILITY NUMBER:
283003772
ADMINISTRATOR:BROWN, MARIA/CORYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 254-9163
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY:14CENSUS: 9DATE:
02/10/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Maria BrownTIME COMPLETED:
01:45 PM
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An annual inspection was made to the facility by Licensing Program Analyst (LPA) Kevin O'Connell. A review of staff records on 02/10/2020 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are 2 adults living in the home. During today’s inspection the home and grounds were toured with the Licensee at 12:25pm. Operating hours are 7:30am to 6:00pm, Monday- Friday. Today, the Licensee and her assistant/ daughter were supervising eight preschool children and one infant. Capacity & ratio are met. The floor plan was verified.
The off-limits areas of the home were made inaccessible by door latches and door handle locks. The fireplace is barricaded with a white wooden gate preventing access.
Licensee states that there are no poisons but knows to lock them. The back yard is used by children for outdoor play and is completely fenced.
The home was observed to be clean and orderly, and was at a comfortable indoor temperature. There were safe toys and equipment available for children. There is a working telephone in the home. Items which could pose a danger to children (such as detergents, cleaning compounds, medications, etc.) were observed to be stored out of the reach of children. The LPA observed a working smoke and carbon monoxide detector and a charged fire extinguisher rated at least 2A:10-BC. The roster of children in care was reviewed and was current and a fire disaster drill was conducted within the past six months (02/20).
Pediatric CPR and First Aid certifications were current and expire 12/2021.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2020
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,
, CA
FACILITY NAME: BROWN, MARIA & CORY FCCH
FACILITY NUMBER: 283003772
VISIT DATE: 02/10/2020
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Licensee states that there are no guns or dangerous weapons and none were observed. Licensee states that there are no water features and none were observed.
Nine children's records were reviewed at 12:40PM for Immunizations and signed Notification of Parent’s Rights forms and all were present. Two staff files were reviewed at 12:50PM. Immunizations and Mandated Reporter Training certificates were current.
The Incidental Medical Services (IMS) policy was discussed with the Licensee. The licensee is not providing Incidental Medical Services (IMS) to children in care at this time as there is not a need. 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 is provided: US Department of Justice toll-free ADA Information Line at (800) 514-0301 (voice)/(800) 514-0383 (TTY) and link to publication: Commonly Asked Question about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

This report, as well as the AAP Guide to Safe Sleep, Safe Sleep in Childcare brochure, What does a Safe Sleep Environment Look Like brochure & Safe Sleep Concepts handout, were reviewed and discussed with the Licensee. The Effects of Lead Exposure brochure has been reviewed with and discussed with Licensee.

All licensing reports are public information and must be made available upon request for at least three years. No deficiencies were cited today.

Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2020
LIC809 (FAS) - (06/04)
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