376100333-2-6-2020-51-CC-TSOA-BLJPJA-20200206102114

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100333
Report Date: 02/06/2020
Date Signed: 02/06/2020 10:21:37 AM

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:	WOOD, MARZIA LOMBARDO		FACILITY NUMBER:	376100333
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 2	DATE:	02/06/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Marzia Wood		TIME COMPLETED:	10:30 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's (LPA's) Tresha Souza and Nancy Diaz conducted an announced pre licensing inspection with applicant, Marzia Wood. Also present in the home was applicant's 2 year old Daughter and one other child. Purpose of the inspection is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This one story, two bedroom, two bath home was toured and inspected. Applicant will use the following areas for child care: living room, family room, bathroom #1 located off hall way, and kitchen. Off limits areas of the home include: both bedrooms, master bedroom. master bathroom and 2nd bedroom made off limits by the use of a door hooks, Applicant will utilize the backyard for outdoor play. There are no bodies of water observed during time of visit. The fire extinguisher is rated 2A 10B:C and is empty and located in Laundry area. Smoke and carbon monoxide detectors meet requirements and are operational. All detergents, cleaning compounds, and medicines are inaccessible to children in care and are secured out of reach of children. Children’s toys and play equipment are available. The applicant has a working telephone/cell phone. Applicant indicated there are firearms in the home and are under lock and key. Ammunition is located in separate area in Master Bedroom in locked safe. Applicant maintains documentation of proof of control of property for review by the Department. Applicant will complete the 8 hours of preventative health on February 7th. Applicant will complete Pediatric CPR and First Aid class on February 9th. Applicant and adult residents in the home have criminal record clearances and/or exemptions on file. See LIC809-C continuation page...

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Tresha Souza	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020

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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: WOOD, MARZIA LOMBARDO	FACILITY NUMBER: 376100333
	VISIT DATE: 02/06/2020

NARRATIVE

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Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon their 18th birthday must be fingerprinted within 30 days. Immunization records per SB792 were reviewed and are in compliance. LPA advised that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. Applicant states they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes. The hours of operation are Monday through Friday, 8:00 a.m. to 5:30 p.m.

Applicant does not plan on providing Incidental Medical Services (IMS) to clients at this time. 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

The New Provider Resource Packet was reviewed with the applicant including information on the following: Safe Sleep, Lead Exposure, SIDS, shaken baby, child abuse reporting, community resources, children’s records, facility records, required postings, immunization's, unusual incident report, facility roster, car seat law, visual for ratio/capacity, fire/disaster drill log and discussed California Megan's Law and LPA provided the following: www.meganslaw.ca.gov. Applicant was also informed the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care.

LPA discussed the maximum capacity for a small family child care home: four infants only (infants mean any children under 24 months); or six children with no more than three infants; or, with landlord consent (owner), eight children with no more than two infants, one child in kindergarten or elementary school and one child at least age six, including children under age 10 who live in the home. See LIC809-C continuation page...

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Tresha Souza	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020

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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: WOOD, MARZIA LOMBARDO	FACILITY NUMBER: 376100333
	VISIT DATE: 02/06/2020

NARRATIVE

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Applicant is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. Duty Line was provided: (619) 767-2248.

Southern California Child Care Advocate information was provided and applicant was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

The following corrections are needed prior to the issuance of the license and to be submitted to the department by 02/15/20 :

CPR & First Aid Certificates.
8 Hour Preventative Health class.
Power outlet covers.
Laundry door needs to be latched.
Fire Exstinguisher needs to be refilled.

A Regular Small Family Child Care Home license may be issued once corrections are received and upon final file review. LPA's Tresha Souza and Nancy Diaz explained inspection report to applicant, applicant stated she understood. An exit interview was conducted and a copy of the report was provided to the applicant.

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Tresha Souza	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2020

LIC809 (FAS) - (06/04)

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