414001266-1-23-2020-05-CC-BVAN-BL4SXV-20200123131634

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001266
Report Date: 01/23/2020
Date Signed: 01/23/2020 01:16:39 PM

COMPREHENSIVE INSPECTION

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:	PADILLA, NANCY A.		FACILITY NUMBER:	414001266
ADMINISTRATOR:	PADILLA, NANCY A.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 455-1410
CITY:	BURLINGAME	STATE: CA	ZIP CODE:	94010
CAPACITY:	14	CENSUS: 7	DATE:	01/23/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:55 AM
MET WITH:	Nancy Padilla		TIME COMPLETED:	01:30 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	Licensing Program Analyst (LPA), Van conducted an unannounced annual inspection and met with Licensee, Nancy Padilla. The purpose of the inspection was explained and granted entry to the home by the licensee. Present, there are 7children (all preschoolers) in care with the licensee and two helpers. All adults living or working in the home have a criminal background check on file. The licensee lives in a single-family home. Day Care Areas: Living Room, Play Room # 1, Play Room # 2, Bathroom, Kitchen, Hallway and Backyard. Off limit areas: Garage, Master Bedroom and Front Yard. Days and operation hours are 8:30 am – 1:30 pm, Monday - Friday. Per Licensee, sick children will be separated from the group and will be waiting in playroom #1’s loft for the parent to pick up. LPA and licensee inspected the daycare areas for health and safety hazards. During the inspection, LPA observed the following: The daycare area is clean, orderly, and equipped with age-appropriate toys and equipment for the children. The home has adequate lighting and ventilation. Home has a working telephone, working smoke and carbon monoxide detector, and a fully charged fire extinguisher. First aid supplies are available for children. Per licensee, there are no firearms or weapons in the home. The licensee stated she has two cats and two dogs, per licensee, all pets are situated in the off-limit areas. LPA observed no pools, spas, or other bodies of water on the premises. During the inspection, LPA observed two areas, the kitchen and the bathroom where cleaning products are accessible to daycare children. The licensee and helper have immediately removed the cleaning products to an off-limit area. LPA reminded the licensee to always kept cleaning products inaccessible to children. LPA observed licensee had posted all the required forms (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, and Emergency Disaster Plan). Per licensee, fire drills are conducted monthly and documented accordingly, and the last fire drill was performed on 12/3/2019.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

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: PADILLA, NANCY A.	FACILITY NUMBER: 414001266
	VISIT DATE: 01/23/2020

NARRATIVE

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During the inspection, LPA reviewed the children's records, licensee's records, and helper's records. LPA observed, identification and emergency information form for every child for proper names, and numbers filled. Licensee and helpers have a record of immunization and certificates of completion of mandated reporter training. Licensee and one helper have a valid Pediatric FirstAid and CPR in file.

LPA discussed the following with the licensee. The licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Also, Licensee was given information regarding 'Safe Sleep' practices, and LPA discussed the Family Child Care Home checklist with the licensee. LPA provided the checklist to the licensee as a reference for future inspection guide.

No deficiencies were observed today. A copy of this report was reviewed and provided to the licensee. This report will be kept in the facility file and will be made available for public review upon request. Notice of Site Visit was observed to be posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

LIC809 (FAS) - (06/04)

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