434413300-1-8-2020-07-CC-MSMS-BKMVCD-20200108151857

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413300
Report Date: 01/08/2020
Date Signed: 01/08/2020 03:19:04 PM

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:	CHAPPUIS, ISABELLE		FACILITY NUMBER:	434413300
ADMINISTRATOR:	CHAPPUIS, ISABELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 520-4804
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95131
CAPACITY:	14	CENSUS: 6	DATE:	01/08/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Isabelle Chappuis		TIME COMPLETED:	03:45 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) Mel Matos met with Isabelle Chappius, Licensee, for an unannounced annual/random inspection. LPA also observed six napping preschool children in the home during today's inspection. Days and hours of operation are Monday - Thursday from 9:00 AM to 4:45 PM. The adults residing in the home are: Licensee and her spouse (Duc Nguyen). The Licensee also has two minor children, ages 16 & 14 years, residing in the home. The Licensee, Licensee's spouse, and two adult assistants have current CPR & First Aid certifications and both certifications expire on January 27, 2021. LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on November 15, 2019. LPA reviewed six children's files and observed current and updated immunization records and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A) in each child's file. LPA also reviewed complete files for two adult assistants (Deciejoy Moreno and Samia Ziadeh) during today's inspection. LPA reminded the Licensee that all staff must either "opt out" or retake their flu vaccinations every year. LPA toured the indoor and outdoor areas of the home during today's inspection. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is clean, orderly, and safe for the day care children. The Licensee has proper heating/cooling and ventilation in the home. LPA did not observe any wall heaters or fireplace units inside the home. Off limit areas in the home: master bedroom, master bathroom, two bedrooms, and attached garage. There are no stairs inside the home. Off limit areas outside the home: one locked storage shed and left side area of the backyard. LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, fenced backyard, and no bodies of water. The Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. All poisons are inaccessible to children and stored in the locked storage shed, located in the backyard. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 01/08/2020):

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CHAPPUIS, ISABELLE	FACILITY NUMBER: 434413300
	VISIT DATE: 01/08/2020

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 01/08/2020):

A review of staff records on January 7, 2020 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, 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.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time with at least two qualified adults present. The Licensee understands that she must comply with the capacity and ratio requirements of the small Family Child Care Home License whenever there is only one qualified adult present in the home. The Licensee states that she does not administer any medication at this time. The Licensee states that she does not transport children.

LPA conducted an exit interview with the Licensee prior to the conclusion of today's inspection and advised her that no deficiencies issued during today's inspection.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

LIC809 (FAS) - (06/04)

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