406215469-8-26-2021-17-CC-MKST-C69PEL-20210826111519

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215469
Report Date: 08/26/2021
Date Signed: 08/26/2021 11:15:25 AM

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:	VALDEZ FAMILY CHILD CARE AKA NATALIE'S PLAYHOUSE		FACILITY NUMBER:	406215469
ADMINISTRATOR:	NATALIE ALEXANDRA VILLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 286-0131
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY:	14	CENSUS: 3	DATE:	08/26/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Natalie Valdez (AKA Valdez)		TIME COMPLETED:	11:20 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	On 08/26/2021, at 10:20am, Licensing Program Analyst (LPA) Melissa Stewart met with Licensee, Natalie Valdez (AKA Villa). A Facility Risk Assessment was conducted and all responses indicated non COVID-19 exposure. LPA explained the purpose and the nature of the 1 Year Required Inspection. Licensee, Assistant and two (2) of the three (3) children present were wearing face coverings. There is a sink outside of the front door where children wash hands and temperatures are checked prior to children entering the Family Child Care Home (FCCH). Child care services are provided in the the living room and backyard. LPA observed age appropriate toys, books and child sized tables and chairs in the living room. There is fireplace in the living room which has a glass screen. There are safety gates at both entrances to the kitchen making it inaccessible to children. The Fire Extinguisher is mounted on the wall in the kitchen with a service date of 5/5/2020. LPA observed Licensee call to schedule an appointment for the fire extinguisher to be serviced on 8/27/21 at 9am. There are three (3) bedrooms and (3) bathrooms. The bedrooms and two (2) bathrooms are off limits to children in care. The first two bedrooms have latches near the top of the door. There is a safety gate in the hallway making the third bedroom and garage door inaccessible to children. The bathroom used by children is equipped with soap and paper towels and is clean and free of toxins. Licensee stated there are no guns or ammunition in the home. Smoke and Carbon monoxide detectors were tested and found to be operational. Licensee completes and documents emergency drills. The most recent drill was held on 5/3/21. LPA observed the outdoor activity area which is accessed through the sliding glass door in the living room. There are a variety of toys and outdoor activity equipment. There is a covered patio and age appropriate riding toys. Continued on 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: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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: VALDEZ FAMILY CHILD CARE AKA NATALIE'S PLAYHOUSE	FACILITY NUMBER: 406215469
	VISIT DATE: 08/26/2021

NARRATIVE

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Licensee has two (2) small dogs in a fenced area on the side of the home.

Licensee has current Pediatric CPR and first aid expiring on 5/21/2023. Licensee and Assistants have met SB 792 immunization requirement and completed Mandated Reporter Training per AB 1207 within the past two years. Child Care Facility roster and a sample of children's files 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 (PUB515) 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, Natalie Valdez (AKA Villa), 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: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

LIC809 (FAS) - (06/04)

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