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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621823
Report Date: 02/20/2020
Date Signed: 02/20/2020 10:14:47 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:VALENCIA, EMILIAFACILITY NUMBER:
343621823
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
02/20/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Emilia ValenciaTIME COMPLETED:
10:20 AM
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Licensing Program Analyst (LPA) Kelly met with licensee for the purpose of an annual/random inspection. LPA toured the home inside and backyard. There were 2 day care children in care.

Off-limit areas: Entire second floor and garage.
Today, the home was inspected inside and out and the following was observed by LPA, all play areas were inspected:
-Knives, medications, first aid kit, and cleaning compounds were inaccessible to the children.
-LPA observed combination working Smoke, and a Carbon Monoxide detectors, and a fully charged 2A10BC fire extinguisher were in compliance.
-Current CPR/First Aid certificate.
-Backyard is fenced, free from apparent safety hazards, and there were no bodies of water on the property.
-The toys appear to be safe and in good condition
-All sharp knives are stored out of reach
-Fireplace is blocked, and licensee stated she does not uses it.
-Licensee stated there are no weapons/firearms in the home
-All adults in the home are fingerprint cleared
-Cleaning compounds are stored out of reach of children
-The bathroom was free of any hazardous items
-Medication are out of reach of children
-Posted license, parents rights, and emergency disaster plan
-LPA reviewed children's record, roster and fire drills documentation
--LPA discussed and reviewed Health & Safety code: 1597.622 Employees or volunteers at family day care home; immunization requirements; records; exemptions with licensee. Incidental Medical Services (IMS) policy was discussed. 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 and the ADA, available at: http://www.ada.gov/childqanda.htm
-There is a working telephone in the home
-LPA did not observed children alone in parked car
-Provided licensee with website www.ccld.ca.gov to obtain forms and Title 22 Regulations.

Home was in compliance at time of inspection
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Socorro KellyTELEPHONE: (916)216-7792
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020
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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