376101045-3-14-2022-51-CC-ALMA-CCHRZS-20220314132824

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101045
Report Date: 03/14/2022
Date Signed: 03/14/2022 01:28:50 PM

Document Has Been Signed on 03/14/2022 01:28 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:	AMARAL DA SILVA, ALESSANDRA FAMILY CHILD CARE		FACILITY NUMBER:	376101045
ADMINISTRATOR:	A. AMARAL DA SILVA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 214-5521
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92117
CAPACITY:	14	CENSUS: 0	DATE:	03/14/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Alessandra Amaral Da Silva		TIME COMPLETED:	01:45 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 3/14/22 at 11:50 AM Licensing Program Analyst (LPA) Adrian Mangina conducted an announced change of location inspection with the applicant. The three-bedroom, one-bathroom one story home was toured and inspected to ensure an environment safe for the care and supervision of children. A copy of the rental agreement was provided as proof of control of property. Applicant states that they have sufficient financial resources to sustain the license. 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 in the home, persons who provide care and supervision to children, and staff who have contact with children, 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. Applicant rents the home and has provided the Landlord Notification Form. Licensee’s First Aid and CPR expire on 2/26/2023 and preventative health practices supplemental Lead Poisoning Training course was completed on 6/28/21 . Mandated Reporter Training AB 1207 was completed on 3/21/21. Assistant’s First Aid and CPR expire on 2/23/2024 and Mandated Reporter Training was completed on 3/7/2022. Staff immunization requirements per SB792 were met. Applicant has the required immunizations. Applicant states that there are no weapons in the home. Applicant will be using the following rooms for childcare: kitchen, dining area, living room, bedroom #1, bedroom #2, bedroom #3, hallway, and bathroom. The following areas will be off limits: side yard (continued on LIC809 page 2)

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: AMARAL DA SILVA, ALESSANDRA FAMILY CHILD CARE	FACILITY NUMBER: 376101045
	VISIT DATE: 03/14/2022

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
26
27
28
29
30
31
32

(LIC809 page 2)

accessed by kitchen door and attached garage. The off-limit areas have safety latches, locks, doorknob covers, or gates installed to prevent access. There is a wood stove in the living room which is screened and barricaded to prevent access. There are no bodies of water on the property.

The 2A10BC fire extinguisher located in the dining area and the combination smoke detector/carbon monoxide detector located in the hallway meet requirements and are all operational. All hazardous items were latched/locked and secured out of reach of children. The applicant has sufficient toys and equipment available. Outdoor play area is the fully fenced back/side yard. There is another portion of the yard accessed through the kitchen door which is not accessible to children in care through use of a doorknob cover.

The new provider packet was reviewed with the applicant including information on ratios and capacity, child abuse reporting, children’s records, immunizations, adults living or working in the home, car seat law, shaken baby syndrome, SIDS, safe sleep practices, effects of lead poisoning, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers, and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided applicant with the following information:
· Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov.
· For common questions or questions regarding licensing requirements to contact the Child Care Licensing duty line at 619-767-2248.
·
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

(continued on LIC809 page 3)

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: AMARAL DA SILVA, ALESSANDRA FAMILY CHILD CARE	FACILITY NUMBER: 376101045
	VISIT DATE: 03/14/2022

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
26
27
28
29
30
31
32

(LIC812 page 3)

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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information , see PIN 22-02-CCP. A Plan for Providing IMS was 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 reviewed with Licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted

Entrance Checklist was provided to the applicant.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Applicant has not obtained landlord consent and will be limited to care for 12 children including any children living in the home under ten years old. Licensee understands that landlord consent is required to care for 14 children.

No corrections are needed. A large license for up to 14 children may be granted upon final file review.

Exit interview conducted and report was reviewed with the Licensee Alessandra Amaral Da Silva.

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3