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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621823
Report Date: 04/10/2020
Date Signed: 04/11/2020 05:50:16 PM

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: 7DATE:
04/10/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Emilia ValenciaTIME COMPLETED:
01:26 PM
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LPA Kelly met with Licensee and conducted a Tele-inspection via FaceTime due to Covid-19 emergency at the family child care home for a case management visit for the purpose of increasing capacity from 8 to 14 children. This is a 2 story The home is a 2 story, 4 bedrooms and 3 bath house. On 4/10/20 at 12:25pm, LPA observed through FaceTime as LPA directed the licensee to toured the areas use by the day care children.

Off limit areas include: Entire second floor and garage.

The home has a 3-A-40 BC fire extinguisher and an operable smoke alarm. All soaps, detergents, sharp kitchen knives and other sharp utensils have been stored according to regulations. Licensee stated there are no firearms in the home. The backyard is fenced and there were no bodies of water. Applicant has current required 15 hours of preventative health training and proof of current 1st aid and CPR certificates. All adults residents have criminal record and Child Abuse Index clearances. Licensee obtained the $300,000 liability insurance through State Farm Insurance. LPA discussed Regulation 1597.622 (Employees and volunteer immunization) with licensee.

The Fire Safety Inspection Clearance has been received from the Fire Marshal and home has been cleared for up to 14 children. Inspection was made on 3/12/20.

No deficiencies cited this date.

Effective date: 4/10/20, Licensee is license to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of 2 years. When there is no assistant present, then it will fall back to the small capacity.

Report was provided and signed via email.

SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Socorro KellyTELEPHONE: (916)216-7792
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2020
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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