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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000300
Report Date: 12/14/2022
Date Signed: 12/14/2022 11:50:27 AM


Document Has Been Signed on 12/14/2022 11:50 AM - 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:AGUADO, SUSAN & CARMICHAEL, CHRISTINEFACILITY NUMBER:
414000300
ADMINISTRATOR:S. AGUADO & C. CARMICHAELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 572-2411
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY:12CENSUS: 9DATE:
12/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Christine CarmichaelTIME COMPLETED:
12:00 PM
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On December 14, 2022 at approximately 8:30am, LPA conducted an unannounced, annual inspection. LPA met with co-licensee, Christine Carmichael, and explained the purpose of the inspection. Present during LPA's visit included co-licensee, two assistants, and 9 enrolled children (4 infants and 5 preschool age children). Facility is operating within capacity limits and ratio during LPA's visit.

Hours of operation are Monday through Friday 8:00am to 5:30pm. Licensee lives in the home with their spouse. The DAY CARE AREAS are located on the first level of the home only which includes the playroom, family room (napping room), bathroom #1, kitchen, dining area and backyard. The OFF LIMIT AREAS located on the first level are the garage, living room, and entire second level of home.

With licensee, LPA inspected the day care areas for health and safety hazards. LPA observed home to be in good repair with proper temperature and ventilation. LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers and/or blocked by furniture. Home is equipped with a variety of age appropriate toys and equipment. LPA observed cleaning supplies, poisons and other chemicals were stored inaccessible to children in home's high shelves and/or off limit areas.

Home is equipped with a working smoke and carbon monoxide detector, fully charged fire extinguisher and a working phone on site. Phone number listed for licensee is current. Home is also equipped with a fire alarm system. Per licensee, there are no weapons or firearms in the home.

The entire backyard is enclosed with an at least 5 ft. high fence. Backyard includes a pool that is properly covered by a built in tarp, that can sustain the weight of an adult. Backyard was observed to have age appropriate toys and materials that were in good working condition. LPA observed area children play in to also have resilient padding for crawling and walking infants.

LPA reviewed licensing documents to be properly posted near front entrance of home, available for review. Last emergency drill was conducted 11/14/2022. Emergency drills are conducted at least once every six months and are properly logged. Licensee also maintains safe sleep logs for napping infants. Safe sleep logs documents the 15 minute time check sleeping infant was last checked on, sleeping position and signs of discomfort.
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SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: AGUADO, SUSAN & CARMICHAEL, CHRISTINE
FACILITY NUMBER: 414000300
VISIT DATE: 12/14/2022
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LPA reviewed 9 children's records, whom were present during the inspection, which were complete. Children's files have a record of emergency identification information on file. Licensee's CPR certification is current and will expire 12/2024.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://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.

No deficiencies were cited today under CCR, Title 22, Div. 12.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Christine Carmichael.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC809 (FAS) - (06/04)
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