434416440-6-22-2020-07-CC-TDON-BQTTPL-20200622145431

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416440
Report Date: 06/18/2020
Date Signed: 06/22/2020 02:55:01 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:	COHEN-SAVRANSKY, ALIZA		FACILITY NUMBER:	434416440
ADMINISTRATOR:	COHEN-SAVRANSKY, ALIZA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 485-9961
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY:	14	CENSUS: 0	DATE:	06/18/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Aliza Cohen-Savransky		TIME COMPLETED:	12:30 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 a scheduled Tele-Pre-Licensing inspection via video conference call with Applicant Aliza Cohen-Savransky. LPA informed Applicant 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 Applicant. Applicant's reply to the email will serve as acknowledgement that the report was received. Applicant is applying for a license to operate a Large Family Child Care Home with a maximum capacity of 14 at the address listed above. A copy of the control of property is on file. The home was granted a Fire Clearance on 05/19/2020. Applicant has over one years of experience caring and supervising children. The day care will be opened Monday through Friday from 07:00 AM to 07:00 PM for children ages 2 to 10 years old. The house was inspected inside and out with Applicant. Off Limit areas in the home are the whole second floor, and the Garage and two bedrooms at the end of the hall on the first floor. LPA observed that Applicant had barricaded the stairs leading to the second floor to prevent children from accessing the stairs. Backyard is fenced and will be used for outdoor activities. Outdoor play equipment and toys were observed to be in good condition. LPA did not observe any bodies of water on the premises. LPA informed Applicant that should she decides to take the children to outdoor areas that are not enclosed with fencing, Applicant must provide on-site supervision at all times. LPA observed a fully charged 3A:40BC fire extinguisher. Smoke and Carbon Monoxide Detectors were tested and proved to be functioning. The home’s disaster plan of action was discussed along with the requirement for the home to conduct and document fire and disaster drills at least once every six months. LPA reminded Applicant that smoking is not allowed in Family Child Care Homes and baby walkers cannot be used for children in care. LPA observed equipment, and furniture for day care children to use. The home is clean and orderly, with heating and ventilation for the safety and comfort of children in care.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2020

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: COHEN-SAVRANSKY, ALIZA	FACILITY NUMBER: 434416440
	VISIT DATE: 06/18/2020

NARRATIVE

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Applicant stated that there are no weapons such as firearm stored on the premises. The home does not have any pets. Licensee stated that she will continue to ensure that detergents, cleaning compounds, sharps, medicines, and other items which could pose a danger if readily available to children were stored where they are inaccessible, out of reach of children. LPA reminded Applicant that poisons need to be locked.

Applicant has completed 8 hours of training on preventive health and safety practices. Applicant has documented proof of immunity against Measles and Pertussis and her AB1207 Mandated Reporter Training expires on 03/15/2022.

Applicant stated that she and her spouse are the only adults residing at the home. Both have Clearances for Criminal Record and Child Abuse Index Background Checks, and Tuberculosis. LPA reminded Applicant about the applicable civil penalties for those adults who have not received fingerprint clearances, who 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.

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. Applicants stated that she 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 also provided Applicant a copy of the COVID-19 Updated Guidance: Child Care Programs and Providers published by the State of California on 06/05/2020.

Applicant is encouraged to frequent 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 Laws, etc.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2020

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: COHEN-SAVRANSKY, ALIZA	FACILITY NUMBER: 434416440
	VISIT DATE: 06/18/2020

NARRATIVE

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LPA informed Applicant that if she decide to not carry liability insurance for the Family Day Care, she will have to maintain file of affidavits regarding liability insurance signed by each parent of the children that will be enrolled.

LPA reviewed with Applicant the violations that would result in an immediate assessment of civil penalty in the amount of $500.

LPA also 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 Options; (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.

Incidental Medical Services (IMS) policy was discussed. 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.

Exit Interview was conducted, where this report was reviewed with Applicant over a video conference call on 06/19/2020.

Applicant agreed to make the following correction by 06/26/2020:

1. Submit to Licensing Office Applicant's Certification of Completion of Pediatric 1st Aid and CPR Training.

Once the above item is received, Applicant's 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: 06/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2020

LIC809 (FAS) - (06/04)

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