406214451-8-31-2021-17-CC-MKST-C6ES5C-20210831133407

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406214451
Report Date: 08/31/2021
Date Signed: 08/31/2021 01:34:14 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	SILVA FAMILY CHILD CARE		FACILITY NUMBER:	406214451
ADMINISTRATOR:	FRANCES SILVA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 423-4465
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY:	14	CENSUS: 2	DATE:	08/31/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Frances Silva		TIME COMPLETED:	01:40 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 8/31/2021 at 12:10pm, Licensing Program Analyst (LPA) Melissa Stewart conducted a Facility Risk Assessment for COVID19 with Licensee, Frances Silva. Licensee reported that four (4) children in care had tested positive in the last 14 days. The purpose of the visit, Required 1 year inspection, was explained. All adults wore face coverings. LPA observed the required documents posted inside of the home on the wall adjacent to the front door. There were two children sitting at the dining table eating lunch supervised by an adult Assistant. Licensee stated that children over the age of 2 years are encouraged to wear face coverings while indoors. Licensee accompanied LPA on a tour of the home inside and out. Child care services are provided in the the living room, dining room, and backyard. LPA observed age appropriate toys and children's cubbies indoors. There is fireplace in the living room which has a metal safety screen. There are three (3) bedrooms, two (2) are off-limits and kept locked by door knob lock. The third bedroom was previously used for child care, but is currently used for storage and is kept locked. The bathroom used by children was observed to be clean and free of toxins. The backyard is completely fenced. LPA observed a variety of equipment outdoors such as playhouses, small climber, play kitchen, gazebo for shade and picnic table. No bodies of water were observed. Licensee stated there are no guns or ammunition in the home. Detergents, cleaning compounds, medications and other items such as kitchen knives which could pose a danger to children are stored inaccessible to children. Smoke and Carbon monoxide detector was tested at 12:21pm and found to be operational. LPA observed the 2 A10 BC fire extinguisher with a service date of 7/16/2021. Licensee was reminded to service or replace the fire extinguisher yearly. Licensee completes and documents emergency drills. The most recent drill was held on 5/23/2021. Licensee called San Luis Obispo County Department of Public Health for guidance regarding the children and families who have tested positive within the last 14 days. Continued 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: SILVA FAMILY CHILD CARE	FACILITY NUMBER: 406214451
	VISIT DATE: 08/31/2021

NARRATIVE

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Dr. Rosen strongly recommended that all the children who had been in care on 8/25/2021 be tested for COVID19 and that all persons over two (2) years wear a face covering both indoors and outdoors until 9/4/2021. After that date, face coverings are only required indoors.

Licensee has current Pediatric CPR and first aid expiring on 10/24/2021. Licensee has met SB 792 immunization requirement and completed Mandated Reporter Training per AB 1207 on 2/20/2018. Licensee stated that she and Assistant will renew the AB1207 training and submit a copy of completion certificate to LPA on or before 9/10/2021. Facility roster and a sample of children's records were reviewed and found complete.

Infant Safe Sleep Regulation section 102425 was discussed. LPA provided PIN 20-24-CCP, Individual Infant Sleep Plan (LIC9227) and a sample Infant Sleep Log for 15 minute checks of all children under the age of two (2) years. Licensee reported that the “Effects of Lead Exposure” brochure is distributed to all families at time of enrollment. LPA advised Licensee that Title 22, Division 12 regulations for Family Child Care Homes and California Department of Public Health COVID-19 guidelines for child care programs can be accessed on-line at www.cdss.ca.gov. Licensee stated that she is subscribed to receive Provider Information Notices (PINs) from Community Care Licensing Division via email.

Incidental Medical Services (IMS) policy was discussed. Licensee stated that there are no children enrolled who require medications at this time. 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: www.ada.gov/childqanda.htm

In the areas evaluated today, no deficiencies were cited.

A copy of this report and appeal rights were discussed and left with Licensee, Frances Silva, whose signature on this form confirm receipt of these documents.

LPA provided a Notice of Site Visit (LIC 9213) to be posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021

LIC809 (FAS) - (06/04)

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