393623022-8-11-2021-53-CC-CJAN-C5SNXF-20210811105105

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393623022
Report Date: 08/11/2021
Date Signed: 08/11/2021 10:51:15 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	PADILLA, GIULIANA		FACILITY NUMBER:	393623022
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	08/11/2021
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Giuliana Padilla		TIME COMPLETED:	11:00 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 (LPA) Christopher Jackson met with licensee Giuliana Padilla for the purpose of a Capacity Increase from 8 to 14 children. LPA Jackson toured all areas of the home two story home that are accessible to children, today’s census included three children in care. All adults in the home have been finger print cleared through Community Care Licensing. Licensee stated there are no new residents in the home since licensure. Off-limit areas include: entire upstairs, garage, and back yard shed . Licensee acknowledged that children may never enter these off-limit areas. LPA observed a current roster of the enrolled children and fire drill log. LPA discussed fire drills were conducted at least once every six months and documented. The Fire Safety Inspection Clearance has been received from the Lathrop-Manteca Fire department, on 8/3/21 clearing the home for up to 14 children. LPA observed cleaning supplies properly stored out of reach of children. Fireplace is properly covered. Licensee stated there are no weapons in the home. LPA observed a Fire extinguisher (2A10BC), smoke detector, and carbon monoxide that meet regulation. LPA observed the toys have no broken parts or sharp edges. The backyard is fenced in. LPA observed a wooden play structure. LPA observed the play equipment does not have any broken boards or sharp edges. LAP discussed with licensee that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes. LPA discussed the infant safe sleep regulations with licensee. LPA discussed the 15 minute checks to be conducted with all infants 24 months and under during nap time. LPA reminded licensee to log the the 15 minute checks. LPA provided a copy of the LIC 9227 infant sleep plan to licensee for use with all infants 12 months and under enrolled in the home. LPA discussed the Mandated Reporter Training with licensee and discussed the two year renewal of the training. LPA provided the link for the training to the licensee at http://www.mandatedreporterca.com/. Report Continues on 809-C

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: PADILLA, GIULIANA	FACILITY NUMBER: 393623022
	VISIT DATE: 08/11/2021

NARRATIVE

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Large family child care home capacity limitations were reviewed during today's visit. Licensee acknowledges that when there is no assistant present, facility will revert back to the small capacity. Licensee acknowledges that children residing in the home under the age of 10 years shall be included in capacity

LPA observed a current CPR/First Aid certificate Exp 07/22. LPA reviewed one children’s files during today's inspection and observed the file contained emergency contact information and signed Notifications of Parents’ Rights and was complaint with title 22 regulations. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA advised licensee to visit the licensing website at http://www.ccld.ca.gov for current forms, laws, regulations and legislation. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

Effective today, 08/11/21, LPA is granting a license to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of 2 years old.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021

LIC809 (FAS) - (06/04)

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