414004842-10-11-2021-05-CC-LGOZ-C7PPUD-20211011113722

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004842
Report Date: 10/11/2021
Date Signed: 10/11/2021 11:37:33 AM

Document Has Been Signed on 10/11/2021 11:37 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:	DAVILA, REGINA ELIZABETH		FACILITY NUMBER:	414004842
ADMINISTRATOR:	DAVILA, REGINA ELIZABETH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 209-6827
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/11/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Licensee, Regina Davila		TIME COMPLETED:	11:50 AM

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On 10/11/2021 at 9:00 A.M., Licensing Program Analyst (LPA), Luis J. Gomez met with Licensee, Regina Davila for a scheduled Change of Location (Large Capacity) inspection at the new facility. Licensee’s previous license is #414004548. Purpose of the inspection was explained. Present during inspection was the licensee and no children. Licensee rents the home, which is a three -bedroom and two -bathroom, one- level house. Current lease agreement has been submitted to the Department. Days and Hours of operations are: Monday – Friday, 8:00 A.M., to 5:00 P.M. Day-care Areas: Living Room (Playroom), Bedroom #2 (Napping Only) , Bedroom #3 (Napping Only), Bathroom #1 and the Outdoor Play Area. Off-limit Area: Bedroom #1, Garage, Kitchen and Bathroom #2. Home was inspected, inside and outside, with licensee for health and safety hazards.

At 9:05 A.M., LPA observed the following: Day-care area was clean, orderly and had a variety of age appropriate toys, books and puzzles for the children. LPA observed individual children’s cubbies located in the entry way for storage. All playthings and accessible furniture inspected were in good repair. Licensee had two child size tables and several chairs for snack and activities. Day-care areas were completely carpeted. For nap time, licensee had playpens located in bedroom #2, #3. Bedrooms were free of hazards or dangerous conditions. In Bathroom #1, located next to playroom, was observed to be in operating condition. Bathroom had adequate supplies for the children. Accessible electrical outlets and trash bins are properly covered. Child gates and safety knob handles had been installed preventing access to the off-limit areas. Facility kitchen will be maintained off-limits. LPA observed detergents, cleaning compounds and other items which could pose a danger, stored in an off-limit area. Fire Alarm was located the facility playroom. Home was the proper temperature, with sufficient lighting and ventilation throughout. Home has a functioning cell phone, smoke /carbon monoxide detector and a fully charged fire extinguisher (3A:40BC), located in the kitchen and playroom.

At 9:30A.M., LPA inspected outdoor play area. Outdoor play area was completely enclosed with tall fencing. All playthings were in good condition. Licensee has shaded rest area for the children. Backyard does not have a swimming pool, spa, hot tub, fishpond or any other bodies of water.

(REFER TO 809-C FOR CONT.)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: DAVILA, REGINA ELIZABETH	FACILITY NUMBER: 414004842
	VISIT DATE: 10/11/2021

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(Page 2)

Isolation of an ill child will be in the playroom. First aid kid is fully stocked. Licensee's CPR/ first aid certification is current and expires: 9/2023. Licensee’s Mandated Report Training is current and expires: 8/11/2022. Per licensee, there are no guns or weapons in the home. Per licensee, she plans to cook all meal for the children. LPA reminded licensee that children's food containers brought to the facility must be labelled and properly stored. The required posters have been posted including: Parent's Rights, Emergency Disaster Plan and Earthquake Preparedness Checklist. COVID-19 posters were posted front door.

Licensee was reminded that all adults 18 years and over living or working in the home, including employee and volunteers, must obtain criminal 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 Child Care Licensing Safe Sleep Webpage at: https://www.cdss.ca.gov/inforesource/child-care-licesning/public-information-and-resources/safe-sleep as an additional resource. LPA informed licensee of the importance of checking for recalled infant devices on United States consumer Product Safety Commission (CPSC) website at http://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) 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 Americans with Disabilities Act (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. (REFER TO 809-C, FOR CONT.)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: DAVILA, REGINA ELIZABETH	FACILITY NUMBER: 414004842
	VISIT DATE: 10/11/2021

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(PAGE 3)

During inspection, licensee submitted the LIC9217, Updated Preventative Health Certification, LIC610A and Vaccine Declaration.

Fire Clearance Approval (STD850) for large capacity licensure was received by the Department on 10/11/2021.

Prior to recommendation for approval for change of location, licensee must complete the following:

-Remove baby bouncers (2) from Family Child Care Home

Copy of the report was reviewed and provided to the licensee. This report will be kept in the facility file and made available for public review upon request. Desk Duty is available Monday through Friday between 8AM - 5PM at (650) 266 -8800.

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2021

LIC809 (FAS) - (06/04)

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