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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700320
Report Date: 09/15/2021
Date Signed: 09/15/2021 11:41:31 AM

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, SORINAFACILITY NUMBER:
435700320
ADMINISTRATOR:PRISACARU, SORINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 960-5859
CITY:PALO ALTOSTATE: CAZIP CODE:
94306
CAPACITY:14CENSUS: 8DATE:
09/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Sorina PrisacaruTIME COMPLETED:
11:55 AM
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On 9/15/2021 at 8:20am, Licensing Program Analyst (LPA) Jonathan Williams met with Licensee (Sorina Prisacaru) for a Required 1-Year Inspection. Present for this inspection are the Licensee, the Licensee's fingerprint cleared and associated assistant provider, and eight children in care (three infants and four preschoolers). Facility operating hours are 8:00-6:00pm M-F. The facility was toured to conduct a Health and Safety Inspection.

The home is a 2-story home. On-limit-areas: Living room and family room ("daycare rooms"), first floor bathroom, first bedroom to the left of the hallway (nap room), backyard area separated by fence from off-limits area. Off-limit areas: Entire second floor, kitchen, two bedrooms at the end of the hallway on first floor, garage, area in backyard separated by fence from on-limits area of the backyard including storage unit. Isolation room: first daycare room closest to the entryway.

At 8:32pm, LPA toured the facility interior. The home is tidy and clean with heating and ventilation for safety and comfort. There are safe age-appropriate toys and learning materials available to children throughout the home. All hazardous materials and toxins including disinfectants and cleaning solutions were observed to be made inaccessible to children during today's inspection. Furniture accessible to children was observed to be age-appropriate, in operable condition, and free of loose, sharp, or pointed parts. Food/beverages capable of rapid spoiling are properly stored. Uncontaminated drinking water is available to children.

At 8:45pm, LPA toured the facility bathroom. Toilets and sinks were found to be in operable condition. LPA observed adequate amounts of paper towels and hand soap available to children in the bathroom during today's inspection. No cleaning supplies were observed to be accessible to children during today's inspection.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan WilliamsTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: 09/15/2021
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At 8:47pm, LPA toured the outdoor play area. All play equipment was observed to be operable and age-appropriate during this inspection. Areas around swings, slides, and high climbing equipment have cushioning material to absorb falls. There are no pools, hot tubs, or any bodies of water on the facility premises during this inspection.

The facility has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. CPR/1st Aid certificate for Licensee expires 3/21/2023. Mandated Reporter training for Licensee expires 9/13/2023 The facility is in ratio today. Children's files and staff files were reviewed for proper documentation. All required forms are posted in public view. Facility roster was obtained. Facility conducts fire/disaster drill at least once every 6 months.

Incidental Medical Services (IMS) policy was discussed. This facility does not provide IMS to children in care at this time. 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.”

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Licensee was reminded that California Law requires licensed Family Child Care Homes to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624b). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the Licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the Licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan WilliamsTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: 09/15/2021
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LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

There are no deficiencies cited. A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided to the Licensee and the signature on this form acknowledges receipt of these rights. Exit interview was conducted and report was reviewed with the Licensee.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan WilliamsTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
LIC809 (FAS) - (06/04)
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