434416286-12-24-2020-07-CC-TDON-BWLLQD-20201224075722

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416286
Report Date: 12/23/2020
Date Signed: 12/24/2020 07:57:34 AM

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:	NOVOA DUQUE, JOSUE		FACILITY NUMBER:	434416286
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	12/23/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Josue Duque Novoa		TIME COMPLETED:	04:45 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) Tuoc Doan conducted an announced, scheduled Tele-Prelicensing inspection of the home via video call. LPA met with Applicant Josue Duque Novoa and explained to him that due to the COVID-19 pandemic and "shelter in Place" Order, this LIC809 Facility Evaluation Report was generated at the Licensing Office and will be emailed to Applicant. Applicant's reply to the email will serve as acknowledgement that he received the report. Also present during the inspection was Kathye Castaneda. Applicant is applying for a license to operate a Small Family Child Care Home with a maximum capacity of eight at the address listed above. Document regarding the control of property is on file. Adults who are over the age of 18 and reside at the home are Applicant and Applicant's cousin. They have Clearance for Criminal Background and Child Abuse Index Check and Tuberculosis. LPA reminded Applicant 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 through Friday from 6:00 AM to 6:00 PM. Applicant completed Preventive Health and Safety training on 11/08/2020 with the additional 2020 Training topic on Lead Exposure Prevention. Applicant's Pediatric CPR/1st Aid Certification expires on 11/05/2022 and his AB1207 Mandated Reporter Training Certification expires on 11/13/2022. Applicant maintains record of his Immunization for Measles and Pertussis. LPA reminded Applicant that should he decides to not carry liability insurance he will need to maintain a file of affidavit signed by the parents informing them about his liability insurance status.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

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: NOVOA DUQUE, JOSUE	FACILITY NUMBER: 434416286
	VISIT DATE: 12/23/2020

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 in the home are the Master Bedroom and Bathroom, two bedrooms down the hallway, Kitchen and Garage. The backyard is fenced and will be used for outdoor activity. LPA informed Applicant that when he takes the children to outdoor areas that are not enclosed with fencing, he must provide on-site supervision at all times. There were no bodies of water observed. Applicant stated that there are no weapons such as firearms stored in the home. LPA observed that Applicant has a fully charged 2A:10BC fire extinguisher. Smoke and Carbon Monoxide Detectors were tested and proved to be functioning. LPA reminded Applicant that fire/disaster drill needs to be practiced 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 Applicant 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.

Applicant stated that the form of discipline to be used are talking and redirecting the children. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Applicant stated that he understands that the children have personal rights that cannot be waived or abridged regardless of consent or authorization from the child’s authorized representative.

LPA went over the records that need to be maintained at the home with Applicant. A Family Child Care Home packet with updated Licensing forms was provided to and reviewed with the Applicant. This packet contains information on documents to be made accessible to the Public and documents to be provided to Parents/Legal Guardians.

LPA discussed with the Applicant about the continuing requirements, which include but are not limited to the following topics: (1) Separating sick children when they show signs of illness; (2) Supervision of Children; (3) Capacity limitation; (4) transportation of children; (5) Procedures for Reporting Suspected Child Abuse and Unusual Incidents/Injuries; (6) Healthy Beverages in Child Care; (7) the Effects of Lead Exposure brochure; and (8) Safe Sleep Practices; and (9) requirement for Adults and Assistant Providers. Applicant understands that he must be present during 80% of day care operating hours. LPA also reviewed with Applicant the violations that would result in an immediate assessment of civil penalty in the amount of $500.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

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: NOVOA DUQUE, JOSUE	FACILITY NUMBER: 434416286
	VISIT DATE: 12/23/2020

NARRATIVE

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Applicant 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.

LPA provided Applicant a copy of the "COVID-19 Updated Guidance: Child Care Programs and Providers" published by the State of California on 07/17/2020 and the "Mandatory Directive: Programs Serving Children or Youth" revised by Santa Clara County Public health on 12/14/2020.

LPA also reviewed recently adopted safe sleep regulations with Applicant and provided him a copy of the LIC9227 “Individual Infant Sleeping Plan” for children 0-1 years old along with the Provider Information Notice
(PIN 20-24-CCP).

Exit interview was conducted, where this report was reviewed with Applicant over the video call.

Based on today's video inspection, LPA determined that the home is in compliance with applicable Health & Safety Codes and Title 22 Regulations. Therefore, Applicant was informed that his application file will be submitted to Licensing Management for the final stage of review.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2020

LIC809 (FAS) - (06/04)

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