414004224-8-2-2019-05-CC-FBRR-BENPQK-20190802113116

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004224
Report Date: 08/02/2019
Date Signed: 08/02/2019 11:32:19 AM

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:	DEL BARCO, LILIANA		FACILITY NUMBER:	414004224
ADMINISTRATOR:	DEL BARCO, LILIANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 281-4731
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94401
CAPACITY:	14	CENSUS: 13	DATE:	08/02/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Liliana Del Barco		TIME COMPLETED:	11:45 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) Faye Bremer conducted an unannounced Annual inspection. LPA met with Licensee Liliana Del Barco and explained purpose of inspection. Upon LPA's arrival, there were 13 preschool aged children, with 2 staff with Licensee present. LPA toured the home and inspected the Day Care areas. Day Care Areas: Dining area, bedroom 1, hallway bathroom, patio and backyard. Off-limits Areas: Living room, kitchen, two remaining bedrooms, garage and back portion of backyard (fenced off). Off-limits areas are made inaccessible to the children by the use of child gates and/or locks. Children are assisted to the bathroom as needed. The home is organized, in good repair, and maintained at a comfortable temperature with proper ventilation. There are no pools or bodies of water at this home, however there is a` covered, empty pond located in the off limits portion of the backyard. Per the licensee, there are no firearms or weapons in the home. The fireplace has a screen, and is located in an off limits area. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. The home is equipped with a fully charged fire extinguisher and working combination smoke and carbon monoxide detectors. The home has a variety of age appropriate toys and other learning equipment available to the children. The licensee has working telephone service, number was confirmed today. Outdoor area is fenced for supervision. Children bring meals from home, and Licensee provides snacks to children. LPA inspected staff and 6 children's records. All children's files inspected were complete with necessary agreements, assessments, Emergency and Identification forms on file. Licensee and staff have current CPR/First Aid expiring 3/2020. Required adult immunization records were observed today. Staff have required mandated reporter training on file. Continued on following page.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye Bremer	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019

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: DEL BARCO, LILIANA	FACILITY NUMBER: 414004224
	VISIT DATE: 08/02/2019

NARRATIVE

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Continued from previous page.

Facility is not currently providing IMS. 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 facilities and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee does not provide care to infants. Licensee provides a space for children if they want to nap, but informs LPA that they do not generally nap.

Emergency drills are conducted and logged, last drill was conducted on Monday, July 25, 2019.

No deficiencies are observed during today's inspection.

A copy of this report was reviewed and provided to the Licensee. Notice of site visit was observed to be posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye Bremer	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019

LIC809 (FAS) - (06/04)

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