434409651-2-5-2020-52-CC-JSAR-BLHSBB-20200205124341

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434409651
Report Date: 02/05/2020
Date Signed: 02/05/2020 12:43:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	MACWILLIAMS, VIRGINIA		FACILITY NUMBER:	434409651
ADMINISTRATOR:	MACWILLIAMS, VIRGINIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 961-8577
CITY:	MOUNTAIN VIEW	STATE: CA	ZIP CODE:	94041
CAPACITY:	14	CENSUS:	DATE:	02/05/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:34 AM
MET WITH:	Licensee		TIME COMPLETED:	12:55 PM

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I, Licensing Program Analyst (LPA), James Sampair, made an Annual Random inspection of the facility that began at 10:25 am. The Licensee, Virginia MacWilliams, was present at the time of the inspection, as was her husband, Cesar Jarmillo, and 1 underage child. Also living at the facility was 1 more underage child.

The Licensee is utilizing the child care roster. The Licensee maintains the capacity on the license. Under care at the time of the inspection were a total of 6 children, 3 infants and 3 preschoolers. The Licensee ensured that children are supervised at all times. Each child has safe, comfortable, and healthy accommodations, furnishings, and equipment.

Licensee rents the facility. The on-limits areas are the back yard and the family room. The home was kept clean and orderly, with heating and ventilation for safety and comfort, as well as safe toys, play equipment, and materials.

The facility had working smoke detectors, carbon monoxide detectors, and fully charged size 2A10BC fire extinguisher. There were no bodies of water. The Licensee stated that there were no guns or weapons in the home. Licensee has 3 pets.

At 10:45 am, 2 employee and 6 children's files were reviewed and found to be complete. The Licensee and employees had current pediatric CPR and first aid. They have not completed the mandated reporter training, because English is a second language for them.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: James Sampair	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MACWILLIAMS, VIRGINIA	FACILITY NUMBER: 434409651
	VISIT DATE: 02/05/2020

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All of the adults meet the criminal background clearance requirement. Licensee was reminded that anyone working, residing or frequently visiting the home must be fingerprint-cleared prior to being in the presence of children or an immediate civil penalty can be assessed.

Also discussed were documents to be provided to parents and legal guardians, including the brochure on Lead Poisoning. Individual Medical Services (IMS) policy was discussed. 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 (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Licensee was given childcareadvocatesprogram@dss.ca.gov to register for all new licensing updates.

There were no deficiencies cited in today's visit. An exit interview was conducted with the Licensee. Appeal rights were given to the Licensee.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: James Sampair	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020

LIC809 (FAS) - (06/04)

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