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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404200
Report Date: 07/14/2022
Date Signed: 07/14/2022 04:06:54 PM


Document Has Been Signed on 07/14/2022 04:06 PM - 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:SABOVIC, LIRIJAFACILITY NUMBER:
434404200
ADMINISTRATOR:SABOVIC, LIRIJAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 264-0405
CITY:SAN JOSESTATE: CAZIP CODE:
95124
CAPACITY:14CENSUS: 7DATE:
07/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Enisa GalveaTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA), James Santos conducted an unannounced Required 1 Year Inspection visit today. LPA met with staff who is also the Licensee's daughter, Enisa Galvea. Licensee, Lirija Sabovic was not present during today's inspection. LPA spoke with Licensee on the phone and discussed the purpose of the visit. Present during the inspection were 7 children whom two (2) are infant age. The home’s operating schedule is Monday through Friday from 7AM to 5:30PM.

LPA toured the home inside and out with staff, Enisa. The License, Notification of Parents’ Rights, Emergency Disaster Plan, and Earthquake Preparedness Checklist were observed to be posted. Off limit areas in the home: master bedroom, master bathroom, guest room and the garage. There are two fireplaces in the home which are covered with glass doors and one of them has an extra barricade. Disinfectant, cleaning supplies, and other hazardous items are stored and inaccessible to children. Furniture and toys and play equipment were observed to be in good condition. LPA observed that there is sufficient amount of toys for children. Bathroom for children was observed to be clean and sanitary. LPA observed a fully charged fire extinguisher, smoke and carbon monoxide detectors. Staff stated that there are no weapons or firearms stored in the premise. Outside play area was observed to be free of hazards. There are no bodies of water observed.

Per staff, they do not transport children but understands that children cannot be left alone and unattended in parked vehicles. Per staff, they currently do not have any children in care who requires Incidental Medical Services.

Six (6) children's files were reviewed during today's inspection. The records reviewed include but not limited to emergency contact information, parent's rights and immunizations.

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SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G SantosTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SABOVIC, LIRIJA
FACILITY NUMBER: 434404200
VISIT DATE: 07/14/2022
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Staff records were reviewed which includes CPR/1st Aid, clearance, immunization records and Mandated Reporter Training certifications. Emergency drills are conducted every 4 months. Per the documentation, the last drill was conducted in June 2022.

LPA reminded staff of the applicable civil penalties for those adults who have not received fingerprint clearance, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

Per staff, they are aware of the Safe Sleep Regulation.

Care providers are encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online Licensing Forms, Adoption of new Laws, etc.


No deficiencies cited during today's inspection.

Exit interview conducted and report was reviewed with staff, Enisa Galvea. Copy of the report was also provided to staff.




NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G SantosTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC809 (FAS) - (06/04)
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