367700174-12-14-2020-12-CC-SMOA-BWAPP6-20201214102901

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700174
Report Date: 12/14/2020
Date Signed: 12/14/2020 10:31:55 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	VIVIER FAMILY CHILD CARE		FACILITY NUMBER:	367700174
ADMINISTRATOR:	ELIZABETH VIVIER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 900-4244
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92308
CAPACITY:	14	CENSUS: 0	DATE:	12/14/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:12 AM
MET WITH:	Elizabeth Vivier Applicant		TIME COMPLETED:	10:37 AM

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	Licensing Program Analyst (LPA) Steven Montoya met with applicant virtually for a prelicensing Inspection. Applicant is requesting to provide care for a Large Family Child Care Home (FCCH) for the capacity of 14 children. Currently residing in the home, are applicant who has Criminal Record Clearances (DOJ/FBI and Child Abuse Index. LPA virtually toured home indoor and out to ensure it meets FCCH requirements. Licensee is requesting the days and hours of operation will be: Monday through Friday 4:00 AM - 11:00 PM. Indoor: The home is set up as follows: This is a 1 story home with 3 bedrooms and 2 bathrooms. Per Applicant the following areas of the home with be utilized for the Family Child Care Home: Living Room, Dining room and Kitchen and Backyard. The off-limits of the home is 3 bedrooms, one Master bathroom and garage which are separated with a child proof gate. There is a fireplace located in the living room which is made inaccessible to children with a glass barrier and a child proof strap. The home has central heating and air conditioning. In the kitchen, all sharp utensils are made inaccessible to children with child safety (magnetic latches) on sink cabinet and drawers. LPA virtually toured the bathroom and inspected sink/toilet are in operable condition. All clean supplies, poison and medications are made inaccessible to children in the garage which is off limits. All unused electrical outlets are plugged clear coverings and made inaccessible to children. LPA observed toys and play equipment to be safe.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 568-8932
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VIVIER FAMILY CHILD CARE	FACILITY NUMBER: 367700174
	VISIT DATE: 12/14/2020

NARRATIVE

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Per Applicant, the children will nap on cots in the front living room with one crib which the LPA observed. There is a fully charged fire extinguisher (2A10BC), smoke detectors, carbon monoxide detector that was tested. LPA observed a fully stocked first aid kit with manual in bag. Applicant states there are no fire arm or weapons in the home or on the premises

Outside:
The backyard play area is clean and free from all trash and debris or dangerous conditions. Play equipment is securely anchored according to manufacturer directions. On the right of the backyard, LPA observed a chain linked fence with lock. LPA observed a wooden shed with a metal security door on it. LPA observed the shed in the backyard that has gardening tools, home supplies and couches. Backyard has 2 play area with canopies cover. LPA observed on the side of home, there is a (27 foot) travel trailer which was inspected. There is no working landline operable, however applicant reports having one cell phone for business purposes that stay at home. There is no swimming pool or bodies of water on the premises.

Documentation:
Applicant has current CPR, First Aid Training with the expiration dates of 10-06-2022 and Prevented Health and Safety Training. All adults in the home have a fingerprint clearance and TB exam. Applicant has proof of being immunized against influenza, pertussis and measles. Applicant has proof of Mandated Reporting Training dated 07-19-2017. Per applicant transportation will not be provided. Per applicant meals and snack will be provided for children.

The following was discussed with the Applicant:
Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 568-8932
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VIVIER FAMILY CHILD CARE	FACILITY NUMBER: 367700174
	VISIT DATE: 12/14/2020

NARRATIVE

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Applicant reminded that 100% supervision is required at all times to children in care. Applicant was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Applicant was made aware that it is he/she responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified

Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.
·On January 1, 2018 or before March 30, 2018, a person who, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the on-line mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatereporterca.com

**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility are aware of situations that present the greatest danger to children.

Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Family child care homes shall post during hours of operation. Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 568-8932
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VIVIER FAMILY CHILD CARE	FACILITY NUMBER: 367700174
	VISIT DATE: 12/14/2020

NARRATIVE

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§1597.622 Employees or volunteers at family day care home; immunization requirements; records; exemptions (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year

**Incidental medical Services (IMS) policy was discussed. Applicant will wait until facility opens to determine IMS needs. 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 Centers and the ADA, available at http://www.ada.gov/childqanda.htm

·Safe Sleep in Child Care: Resources can be found on our website at http://www.cdss.ga.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

·Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 568-8932
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: VIVIER FAMILY CHILD CARE	FACILITY NUMBER: 367700174
	VISIT DATE: 12/14/2020

NARRATIVE

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Applicant advised visit www.shotsforschool.org for Immunization information.

Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

Prior to being licensed the follow is required by: Due (12-16-2020)
· Mandatory reporter training certificate.
· xxxx
· xxxx

****Applicant will be sent LIC 809 for review and sign via email. Applicant will return LIC 809 by 12-16-2020 and given pre-licensing application packet with licensing forms included

**As a result of this inspection, the home does not meet Title 22 Regulations. Corrections are required.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 568-8932
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2020

LIC809 (FAS) - (06/04)

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