434415616-8-14-2020-07-CC-TDON-BSGU74-20200814151920

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415616
Report Date: 08/11/2020
Date Signed: 08/14/2020 03:19:31 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:	PANAMENO, KATHERINE		FACILITY NUMBER:	434415616
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	08/11/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Katherine Panameno		TIME COMPLETED:	04:30 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 announced, scheduled Tele-Prelicensing inspection of the home via video call. LPA met with Licensee Katherine Panameno and explained to her that due to the COVID-19 situation and "Shelter in Place" Order, this LIC809 Facility Evaluation Report was generated at the Licensing Office and will be emailed to Licensee. Licensee's reply to the email will serve as acknowledgement that the report was received. Licensee currently has a Small Family Child Care Home license #434415826 located in Sunnyvale, CA 94087 and is relocating to the address listed above. Document regarding control of property is on file. Adults who are over the age of 18 and reside at the home are Licensee and Licensee's Spouse. They have Clearance for Criminal Background and Child Abuse Index Check and Tuberculosis. 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. Days and hours of operation will be Monday thru Friday from 8:30 AM to 5:30 PM. Licensee has completed Preventive Health and Safety training on 04/24/2018. Licensee is registered to complete the training for the additional 2020 topic in Lead Exposure Prevention on 08/20/2020. Licensee's Pediatric CPR/1st Aid Certification had expired on 04/2020 and Licensee is registered to renew this certification on 10/10/2020. Her AB1207 Mandated Reporter Training Certification expires on 08/04/2022. Licensee maintains record of her Immunization for Measles and Pertussis. LPA reminded Licensee that should she decides to not carry liability insurance and will maintain a file of affidavit signed by the parents regarding her liability insurance.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2020

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: PANAMENO, KATHERINE	FACILITY NUMBER: 434415616
	VISIT DATE: 08/11/2020

NARRATIVE

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LPA inspected the indoor and outdoor areas of the home over the video call. The home was clean and orderly, with heating and ventilation for the safety and comfort of children in care. Off Limit areas are the Master Bedroom and Bath and the Purple Room. The backyard patio is fenced and is used for outdoor activity. Front yard will also be used for outdoor activities. Front yard has fencing but the fencing does not fully enclosed the whole yard. LPA informed Licensee that when she takes the children to outdoor areas that are not enclosed with fencing, Licensee must provide on-site supervision at all times.

There were no bodies of water observed. Licensee stated that there are no weapons such as firearms stored in the home. LPA observed the home has a fully charged 3A:40BC fire extinguisher. Smoke and Carbon Monoxide Detectors were tested and proved to be functioning. LPA reminded Licensee that fire/disaster drill needs to be practiced with the children at this location and needs to be conducted at least once every six months.

Cleaning products, medications, sharp objects and other items that may pose as a danger to children in care were stored inaccessible to children. Poisons need to be locked up. LPA reminded Licensee that smoking and baby walkers are not allowed in family child care homes. There were toys, furniture, play equipment and materials set up for children to use.

Licensee understands that children's personal rights should not be violated; including no corporal punishment. LPA discussed with Licensee about supervision of children, capacity options, and requirements for Assistant Providers. Licensee understands that she has to be present during 80% of day care operating hours. 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.

Incidental 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 (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.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2020

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: PANAMENO, KATHERINE	FACILITY NUMBER: 434415616
	VISIT DATE: 08/11/2020

NARRATIVE

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Licensee has been provided a copy of the "COVID-19 Updated Guidance: Child Care Programs and Providers" published by the State of California on 07/17/2020 and "Mandatory Directive: Programs Serving Children or Youth" published by Santa Clara County Public health on 07/13/2020.

Exit interview was conducted, where this report was reviewed with Licensee over a telephone call on 08/14/2020.

Licensee was informed that Licensee is approved for a 90 days Provisional License to operate a Small Family Child Care Home at this address, effective 08/17/2020.

This Provisional License expires on November 15, 2020.

In order to be issued a regular Family Child Care Home License, Licensee must submit proof of completion of training on the 2020 topic in Lead Exposure Prevention and a renewed Pediatric CPR/1st Aid Certification before 11/15/2020.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2020

LIC809 (FAS) - (06/04)

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