434414734-7-10-2019-07-CC-TDON-BDXUN9-20190710154335

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414734
Report Date: 07/10/2019
Date Signed: 07/10/2019 03:43:41 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:	SUTACHAN, LIDA		FACILITY NUMBER:	434414734
ADMINISTRATOR:	SUTACHAN, LIDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(669) 248-5987
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY:	14	CENSUS: 10	DATE:	07/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Lida Sutachan		TIME COMPLETED:	03:50 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) Tuoc Doan conducted an unannounced Annual Inspection of the Family Day Care home. LPA met with Licensee Lida Sutachan and explained the purpose of the inspection. Present during the inspection were 10 children in care, of whom three were infant age and one is Licensee's own child who is under 10 years old. Licensee, and Assistant Providers Jeimy Sutachan and Evelyn Torrez were present to provide care and supervision to the children. Licensee stated that she understands that when she has more than 12 and up to 14 children, one child has to be attending school and one child has to be at least 6 years old. Licensee also stated that she understands she must comply with the capacity requirement of a small Family Child Care Home license whenever there is only one person providing care and supervision to the children at the home. The home’s operating days and hours are Monday through Friday from 07:30 AM to 05:30 PM. The home maintains telephone service. The License and Notification of Parents’ Rights were observed to be posted. The home was inspected inside and out. The home was clean and orderly, with heating and ventilation for the safety and comfort of children in care. LPA did not observe flies, other insects, or rodents during the inspection. The observed children’s toys, play equipment, and furniture were in good condition. There were no baby walkers at the day care. Bathroom used by children was observed to be clean and in operating condition. Food preparation area was clean. Off limit areas in the home are: the Kitchen, Bathroom 2, Laundry Room, Living Room, walk in closet adjacent to the Living Room, and Bedroom 1. There is a child safety gate installed at the entryway to the Kitchen to prevent children from accessing the area. Backyard is fenced and is used for outdoor activity. The two storage sheds in the backyard were locked. There were no bodies of water observed. Licensee stated that there were no weapons such as firearms stored on the premises.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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

FACILITY NAME: SUTACHAN, LIDA	FACILITY NUMBER: 434414734
	VISIT DATE: 07/10/2019

NARRATIVE

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A fully charged fire extinguisher last serviced on 02/2019 was observed. Carbon monoxide and Smoke Detectors were tested and proved to be functioning. Fire/Disaster Drills were last conducted on 06/11/19. Licensee stated that the day care does not provide transportation to the children but Licensee understands that if they do, children cannot be left unattended in parked vehicles at any time, the motor vehicles used to transport children in care shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system.

LPA reviewed the roster of children in care and obtained a copy. Children’s files were reviewed, which included records of Identification and Emergency Information, Consent for Emergency Medical Treatment, Receipt for Parents' Rights Notice, and Immunization. The files for Licensee and Assistant Providers Jeimy Sutachan and Evelyn Torrez were reviewed. They have Criminal Record and Child Abuse Index Background Check Clearance, TB clearance, Statement Acknowledging Requirement to Report Suspected Child Abuse, Immunization record for Measles and Pertussis, and required Training. Licensee's Pediatric CPR/1st Aid Certification expires on 03/22/20. Licensee's AB1207 Mandated Reporter certification expires on 12/29/20.

Adults who are over the age of 18 and reside in the home are Licensee, Licensee's Spouse, and Assistant Provider/Sister Jeimy Sutachan. They have Clearances for Tuberculosis, Criminal Background Check, and Child Abuse Index Check. LPA 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. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

LPA reviewed with Licensee the violations that would result in an immediate assessment of civil penalty in the amount of $500. Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov [Shortcut: www.ccld.ca.gov] to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility. Safe Sleep information was also reviewed and provided to Licensee.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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: SUTACHAN, LIDA	FACILITY NUMBER: 434414734
	VISIT DATE: 07/10/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. Licensee stated that she currently does not have any children in care who requires IMS. 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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

In the areas that were evaluated, no regulatory violations were observed at the time of the inspection. Exit Interview was conducted, where this report was reviewed and discussed with Licensee.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

LIC809 (FAS) - (06/04)

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