334845665-9-27-2021-09-CC-ATAR-C79UJE-20210927153726

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334845665
Report Date: 09/27/2021
Date Signed: 09/27/2021 05:21:00 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:	RIVERA FAMILY CHILD CARE		FACILITY NUMBER:	334845665
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	09/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Stephanie Rivera-Licensee		TIME COMPLETED:	03:00 PM

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On date and time listed, Licensing Program Analyst (LPA) Andrea Taylor arrived at the facility to conduct a required/annual inspection as part of a compliance review. Licensee, LPA was escorted on tour of the facility, inside and out by Licensee, records were reviewed, and the following was observed and/or discussed:
Normal days and hours of operation are: Monday through Saturday, 6:00am to 6:00pm

OFF-LIMIT AREAS INCLUDE: All bedrooms, the master bathroom and garage

The facility is operating within the licensed capacity and appropriate ratios

· Appropriate supervision provided during this inspection
· A working telephone is present and current number on file
· Appropriate fire extinguisher, smoke detector and carbon monoxide detector present and were tested by the Licensee during this inspection.
· Fireplace is properly screened to prevent access by children
· All hazardous items are stored inaccessible to children
· Toxins are locked
· Weapons are not present according to the Licensee. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations
· Single story home
· Verification of control of property on file
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted
· Mandated Reporter Training completed on 8/31/21
· Pediatric CPR and First Aid Card expire on 9/18/23
· Health & Safety Certificate - completed

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

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

FACILITY NAME: RIVERA FAMILY CHILD CARE	FACILITY NUMBER: 334845665
	VISIT DATE: 09/27/2021

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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.

- Go to the licensing webpage www.ccld.ca.gov, and click on the “Receive Important Updates” located on the right side of the page, immediately above the Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

- The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200

No cited deficiencies during today's inspection.

The LICENSEE, Stephanie Rivera, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

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.

Exit interview conducted and report was reviewed with the licensee Wendy McWilliams.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021

LIC809 (FAS) - (06/04)

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