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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370812434
Report Date: 12/07/2022
Date Signed: 12/07/2022 01:39:31 PM


Document Has Been Signed on 12/07/2022 01:39 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:TANABE, SYLVIA FAMILY DAY CAREFACILITY NUMBER:
370812434
ADMINISTRATOR:SYLVIA TANABEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 697-6519
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY:12CENSUS: 0DATE:
12/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:47 AM
MET WITH:Sylvia Tanabe TIME COMPLETED:
01:45 PM
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On 12/07/2022, at 11:47 a.m., Licensing Program Analyst (LPA), Rajani Goudreau conducted an unannounced Annual Inspection and met with the Licensees, Sylvia Tanabe. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. There were no children in care at time of inspection. The indoor and outdoor areas were toured and inspected. The following areas are used for childcare: living room, dining room, kitchen, and bathroom located in hallway of home. The following off-limit areas are made securely inaccessible: four-bedroom, restroom located in the master bathroom, garage and backyard. Facility operates Monday to Friday from 6:00 a.m. through 6:00 p.m.

The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements, per LPA observation. LPA observed hazardous items inaccessible to children in care. LPA informed licensee’s poisons shall be placed in a storage area and locked. No bodies of water were observed on the premises of property. Licensee confirmed there is no bodies of water on the premises of the property. Licensee stated there are no firearms or weapons in the home. The front yard is used for outdoor activities. LPA informed licensee’s the children shall be supervised during outdoor activities. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Licensee First Aid and CPR certifications are valid and expire in December 2023. Licensee have required immunization’s on file, per file review. Mandated Reporter training for licensee is not on file. LPA informed licensee to ensure the mandated reporter training is completed once every two years. The mandated reporter training can be completed at mandatedreporterca.com. LPA observed required documents posted. A sample of children’s files were reviewed and complete.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2022
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: TANABE, SYLVIA FAMILY DAY CARE
FACILITY NUMBER: 370812434
VISIT DATE: 12/07/2022
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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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . LPA informed licensee in order to sign up for Quarterly Updates and PINs through our website. Please go to www.cdss.ca.gov and on the right side of your screen click on “Receive Important Updates”, put your email address in and choose which program(s) you would like to subscribe to and click “subscribe. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

No deficiencies issued during today's inspection. Technical violation advisory note issued. Exit interview conducted and report reviewed with the Licensee, Sylvia Tanabe. A Notice of Site Visit (LIC9213) was given and must remain posted for 30 days from today’s date. LPA observed Notice of Site Visit posted prior to exiting facility.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022
LIC809 (FAS) - (06/04)
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