435700320-9-18-2020-52-CC-JPLA-BTKQP6-20200918122013

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700320
Report Date: 09/18/2020
Date Signed: 09/18/2020 12:20:29 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	PRISACARU, SORINA		FACILITY NUMBER:	435700320
ADMINISTRATOR:	PRISACARU, SORINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 960-5859
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	14	CENSUS: 0	DATE:	09/18/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Sorina Prisacaru		TIME COMPLETED:	12:15 PM

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On 09/18/2020, at 9:00am, Licensing Program Analyst (LPA) Julia Placencia conducted a Prelicensing Inspection. The Inspection was conducted virtually via Facetime due to the COVID-19 pandemic.

LPA met with applicant Sorina Prisacaru. Also residing in the home is the applicant’s fingerprint cleared spouse Ghenadie Prisacaru and two children (ages 2 and 17 years old). The home was toured with the applicant to conduct a health and safety inspection. Per applicant, the hours of operation for day care will be Monday through Friday, 8:00am to 6:00pm.

The home is two story, which consists of a kitchen, family room, living room, three bedrooms, bathroom and garage on the first floor. The second floor consists of the master bedroom and bathroom, as well as a small office space. There is a backyard with a storage unit. The home is neat and clean with heating and ventilation for safety and comfort.

ON-LIMITS: Living and family rooms are the daycare rooms; first bedroom to the left in hallway is the napping room; first floor bathroom; backyard. The isolation area will be first daycare room nearest the front door.

OFF-LIMITS: Kitchen; remaining two bedrooms at the end of the hallway on the first floor; entire second floor; storage unit in backyard. All off-limit areas will be inaccessible by closed and/or locked doors and visual supervision. The applicant was advised to contact Licensing so that an inspection can be completed prior to changing an off-limits area to on-limits.

***Continued on LIC 809C....

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2020

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PRISACARU, SORINA	FACILITY NUMBER: 435700320
	VISIT DATE: 09/18/2020

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The outdoor play area will be the backyard, which has a fence surrounding the perimeter, and is free from defects and dangerous conditions. There is a wooden play structure that was observed to be anchored to the ground. There is rubber mulch underneath the play structure to absorb falls. There are ample age appropriate toys, inside and outside, which are observed to be safe, clean and in good repair. There are no pools, hot tubs or any other bodies of water.

LPA did not observe any hazardous materials or toxins accessible to children today. The off-limits kitchen has child proof gates at each end of the room. The home has two fully charged 2A10BC fire extinguishers, one of which is located in the back daycare room. There are functioning combination carbon monoxide/smoke detector units on ceilings throughout the home, as well as fully stocked first aid kits. Applicant has installed a child safety gate at the bottom of the stairs to prevent access by children, and is aware the gate must always be secure during daycare hours. The two daycare rooms each have a fireplace, which are secured with boards. There is also an activity shelf blocking one fireplace. Heater vents are located near the ceilings. Per applicant, there are no firearms in the home.

The applicant’s health and safety training has been completed, which includes lead poisoning prevention. First Aid/CPR certificate is current, expiring on 4/07/2021. A copy of the lease agreement has been reviewed and shows control of property. The applicant has provided proof of the required immunizations, and mandated reporter training was completed on 01/27/2020. Forms pertaining to the children’s files and facility files were reviewed and discussed, as well as Safe Sleep practices. Applicant was reminded that children are never to be left in a parked vehicle.

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.

***Continued on LIC 809C...

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2020

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: PRISACARU, SORINA	FACILITY NUMBER: 435700320
	VISIT DATE: 09/18/2020

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The applicant was reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. The applicant was reminded of the responsibility as a mandated reporter.

Applicant was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

This home is recommended for licensure of a large family home effective today, 09/18/2020. The fire clearance was approved by the Palo Alto Fire Department on 07/08/2020.

This report has been read to the applicant in its entirety. Exit interview conducted with Sorina Prisacaru. A copy of report was emailed to applicant, and applicant agrees to sign report and return to LPA.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2020

LIC809 (FAS) - (06/04)

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