334845960-3-11-2021-09-CC-DHOE-BZ23NB-20210311172342

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334845960
Report Date: 03/11/2021
Date Signed: 03/11/2021 05:25:32 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:	SALDIVAR FAMILY CHILD CARE		FACILITY NUMBER:	334845960
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	03/11/2021
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:32 PM
MET WITH:	Christina Saldivar, Licensee		TIME COMPLETED:	04:00 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	Due to COVID-19 State of Emergency on 03/11/2021 at 02:32pm, Licensing Program Analysts (LPAs) Destinee Hogue and Laura Landeros conducted a case management tele-inspection via Microsoft Teams. LPAs met with Licensee Christina Saldivar and were virtually granted access inside the facility. LPAs virtually toured the inside and outside of the facility, census was taken, and facility records were reviewed. Facility was licensed on 11/12/2020. LPAs informed Licensee the purpose of this tele-inspection is to ensure Licensee is in compliance with Title 22 Regulations. During this tele-inspection, LPAs observed and discussed the following with Licensee: Present during this tele-inspection were LPAs, Licensee, Licensee’s minor children, and four daycare children. -Normal days and hours of operation are: Monday-Friday from 7:00am to 6:00pm -OFF-LIMIT AREAS INCLUDE: All bedrooms, garage, bathroom #2 As of 03/11/2021, LPAs observed the facility to be operating within the licensed capacity and appropriate ratios were observed. LPAs observed appropriate supervision during this tele-inspection. During this tele-inspection, LPAs observed personal rights being accorded to the children in care. Licensee, Christina Saldivar provided an updated facility roster (LIC9040) identifying the current children enrolled at the facility. Following review of the updated facility roster, LPAs reviewed a random sample of children records and documented the review of records. During this tele-inspection, LPAs reviewed COVID-19 guidance and practices, as well as discussed COVID-19 reporting requirements and additional COVID-19 resources. LPAs provided a copy of the Spring 2021 Quarterly Update to Licensee during this tele-inspection. LPAs discussed the importance of staying up to date on important updates from the department and informed Licensee to enroll online to receive Provider Information Notices (PINs) and Quarterly Updates from the department. LPAs observed COVID-19 guidance and information posted throughout the facility.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2021

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: SALDIVAR FAMILY CHILD CARE	FACILITY NUMBER: 334845960
	VISIT DATE: 03/11/2021

NARRATIVE

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Licensee was reminded, when her child(ren) turn 18 years of age, she MUST SUBMIT an updated LIC279, LIC508 and TB Screen and have her child submit fingerprints for LIVESCAN background clearance. This also applies to any adult PRIOR to them moving into the home or who currently lives in the home, and PRIOR to employment of any adult, you must submit the items listed above.

Based on the above, at this time the facility was found to be in compliance with Title 22 Regulations.

A NOTICE OF SITE VISIT WAS ISSUED AND LPAS VERIFIED IT WAS POSTED IN A PROMINENT LOCATION PRIOR TO ENDING THE TELE-INSPECTION. LICENSEE UNDERSTANDS THE NOTICE OF SITE VISIT MUST BE POSTED FOR THE NEXT 30 DAYS.

An exit interview was conducted via Microsoft Teams, and a copy of this report was provided to Licensee on this date. Due to COVID-19 State of Emergency, LPA provided a copy of this report via email with an electronic “READ RECEIPT”. LPA requested Licensee to acknowledge receipt of the email. The electronic read receipt of the emailed report acknowledges receipt of this report. Licensee understands that a copy of this report must be made available to the public, upon their request, for the next three years. No deficiencies were cited during this tele-inspection.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2021

LIC809 (FAS) - (06/04)

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