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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002048
Report Date: 06/06/2019
Date Signed: 06/06/2019 03:47:16 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:GATUS, VENETIAFACILITY NUMBER:
384002048
ADMINISTRATOR:GATUS, VENETIA H.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 702-9661
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94127
CAPACITY:14CENSUS: 8DATE:
06/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Venetia GatusTIME COMPLETED:
04:15 PM
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1, Licensing Program Analyst, LPA conducted an annual random inspection today. There are 8 children and 2 staff members present today. Venetia arrived during the inspection. The purpose of the inspection was discussed. Current residents at the facility are Venetia, her children ages 13, 15 yr old. Daycare areas are the same as last year. Day-care areas, the lower level only: entry room, large play area, nap room near the bathroom, and back yard. The remaining areas of the home are off limit. The home is equipped with a smoke detector, fire extinguisher, and a carbon monoxide detector. Facility personnel summary report was reviewed with Venetia and updated during the inspection. Required immunization for staff members are on file. LPA discussed the Mandated Reporter Training, AB1207 certificate for staff members are on file. LPA reminded licensee that Mandated Reporter Training, AB1207 training needs to be renewed once every 2 years. CPR & 1st aid certificate 12/2020.
SIDS "A Child Care Provider's Guide to Safe Sleep" information was discussed and provided during the inspection. During today inspection LPA observed infant walker in the entry room. LPA pointed it out. Staff stated that the parent dropped it off yesterday, and they will return it back to the parent. Last emergency drills was conducted on February 15-2019.


website: www.ccld.ca.gov. Title 22, Div 12, Chp 3
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019
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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