343623597-10-28-2020-03-CC-JHOA-BUTTRV-20201028145811

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623597
Report Date: 10/28/2020
Date Signed: 10/28/2020 02:58:17 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:	VOICOVA, MARIA		FACILITY NUMBER:	343623597
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	10/28/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Maria Voicova		TIME COMPLETED:	02:00 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	On Wednesday, 10/28/20 at 12:30pm, Licensing Program Analyst (LPA), Jan Hoshida, met with Licensee, Maria Voicova, via FaceTime due to COVID-19 pandemic, for the purpose of an increase of capacity inspection. Licensee had applied to change from a Small Family Child Care Home to a Large Family Child Care Home. LPA observed that there were 5 day care children (2 children that are under the age of 2 years of age) and her husband/assistant in the home. The off-limit areas include the entire upstairs, the kitchen with attached dining room, living room and bar/additional sink area, laundry room, bathroom by the laundry room, garage, backyard and pool area. Licensee acknowledged that children may never enter the off-limit areas. Licensee acknowledged that if she would like to change an off-limits area to on-limits, she will inform LPA prior to using the space for inspection and approval. Licensee stated there are no new residents in the home since licensure. All adult residents have criminal record clearances. The hours of operation are Monday through Sunday from 12:00am to 12:00pm. Licensee acknowledged that day care children may not attend the day care for longer than 24 hours at a time. During the FaceTime inspection, LPA Hoshida requested a tour of the facility. LPA and Licensee conducted a health and safety inside and out the home. A fire pull, functioning smoke and carbon monoxide detectors and fire extinguisher were observed in the home. The Fire Safety Inspection Clearance has been received from the Sacramento Metropolitan Fire Department and the home has been cleared as of 10/22/20. There is an in-ground pool on the property which is completely surrounded by a see-through mesh fence that is at least 5 feet high. LPA observed the gate to self-close and self-latch. There are no windows or doors that provide direct access into the pool area. *REPORT CONTINUED ON NEXT PAGE*

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2020

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: VOICOVA, MARIA	FACILITY NUMBER: 343623597
	VISIT DATE: 10/28/2020

NARRATIVE

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LPA observed that there were no hazardous items accessible to children. Licensee stated that she understands that any poisons must be kept under lock and key. LPA observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Toys appear to be safe. The backyard is fenced and gated. Current pediatric CPR and first aid training was verified and expires on 9/18/21. The fireplace was properly screened and inaccessible to children. LPA discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed some children’s files. LPA observed completed sleep logs and Individual Infant Sleeping Plans (LIC 9227) on file.

This facility evaluation report was reviewed and discussed with the Licensee. Records, postings and reporting requirements were discussed. Licensee was encouraged to visit the department website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, self-assessment guides, regulations and legislation pertaining to family child care homes. LPA also included the email address for the children's advocacy program to stay current on new laws CHILDCAREADVOCATESPROGRAM@DSS.CA.GOV.

Effective today 10/28/20, facility is approved for a Large Family Child Care 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 is enrolled in Transitional Kindergarten or above and 1 child at least age 6 with a maximum of 3 infants. Without assistant, the ratios revert to those for small family child care home. An exit interview was conducted and Notice of Site Visit was provided.

Facility evaluation report was emailed to Licensee and an email verification of receipt of report will be used in lieu of a signature on this report.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2020

LIC809 (FAS) - (06/04)

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