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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004143
Report Date: 07/14/2022
Date Signed: 07/14/2022 02:21:17 PM


Document Has Been Signed on 07/14/2022 02:21 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:SILVA, ANA PAULAFACILITY NUMBER:
384004143
ADMINISTRATOR:ALVES, ANA PAULAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 912-0300
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 10DATE:
07/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ana Paula SilvaTIME COMPLETED:
12:00 PM
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Licensing Program Analyst, LPA Yee conducted a required - 1 year inspection today. The purpose of the inspection was explained. Present at the daycare are 10 children (3 infants), 2 helpers and the licensee, Ana Paula. The facility personnel summary report was reviewed with Ana Paula and updated during the inspection. Current residents are Ana Paula, one tenant and her children ages 17 yr old daughter, 14 yr old son. Daycare area: living room, daycare room #1, daycare room #2 (located in the back), kitchen, bathroom, laundry room and backyard. Ana requested to add the laundry room and LPA inspected the room and approved. The remaining areas of the house are off-limits. The home is equipped with a smoke alarm, carbon monoxide detector, and fire extinguisher. The last emergency drill was conducted on 03-04-2022. A log sheet was available during the inspection. The facility participate in a food program. The home is clean orderly and properly ventilated.
No spas, swimming pools, hot tubs, fish ponds, or similar bodies of water are present. Children toys and materials are age appropriate. Licensee and helpers have current Pediatric First Aid and CPR training (exp. 11/2022) and helpers (exp. 1/2024, 9/2023). Staff and children's files were reviewed. Children's files and staff files are in order. Licensee and helpers have the required immunizations on files. Licensee and helpers have verification of the mandated child abuse reporter training competed on file.
LPA discussed Child Abuse Mandated Reporter Training AB1207 with Licensee. As of January 1, 2018 all staff will be required to complete Child Abuse Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://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.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2022
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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