334843712-2-3-2022-09-CC-GCAO-CBB2BS-20220203161536

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334843712
Report Date: 02/03/2022
Date Signed: 02/03/2022 04:15:46 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	BAUTISTA FAMILY CHILD CARE		FACILITY NUMBER:	334843712
ADMINISTRATOR:	CLARISSA BAUTISTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 298-9806
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92507
CAPACITY:	14	CENSUS: 1	DATE:	02/03/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Clarissa Bautista		TIME COMPLETED:	04:20 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	· On 02/01/2022 at 2:00PM Licensing Program Analyst (LPA) Giselle Carbullido arrived at the facility to conduct an annual inspection. LPA was granted entry by Licensee, Clarissa Bautista. LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: Normal days and hours of operation are Monday- Friday, 6AM- 5PM OFF-LIMIT AREAS INCLUDE: Entire backyard (2 areas) down stairs bedrooms except son's room and garage. · The inspection consisted of reviews of the following domain: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio and Capacity, Personal Rights The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. Deficiencies not cited this visit. · The facility is operating within the licensed capacity and appropriate ratios. Licensee's son present. · The Licensee is present in the home and has ensured that children in care are supervised. · When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children · A working telephone is present. · Appropriate fire extinguisher ( closet) smoke detector (Playroom ) and carbon monoxide detector (front entry) are present and were tested by the Licensee during this inspection. All hazardous items are inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children: See LIC9102TA · Storage of poisons is inaccessible to children and locked · There is a properly barricaded fire place: screen and glass doors.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 334843712
	VISIT DATE: 02/03/2022

NARRATIVE

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· No guns or weapons present as stated by the Licensee. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations.
· Home is clean and orderly, with heating and ventilation for safety and comfort
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced and/ or appropriate supervision is present: Off limit area
· Verification of control of property on file
· Pediatric CPR and First Aid Card expired 09/2021 see LIC 9102TV Health & Safety Certificate - completed on 03/05/2016 Mandated reporter expired 4/2021 See Technical advisory LIC9102TV Fire clearance: 08/20/2019 Documentation of fire & earthquake drills to be conducted every six months: No current drill due to no children enrolled since 3/2021
· There are bodies of water, at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Clean, safe and age appropriate toys
· Children’s files are complete
· To receive important licensed- related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
· 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

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 334843712
	VISIT DATE: 02/03/2022

NARRATIVE

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· Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
· LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
· To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
· A notice of site visit was given and must remain posted for 30 days.
· Exit interview conducted and report was reviewed with the licensee Clarissa Bautista.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

LIC809 (FAS) - (06/04)

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