444406107-5-8-2019-07-CC-ZHAM-BBYSJE-20190508135500

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444406107
Report Date: 05/08/2019
Date Signed: 05/08/2019 01:55:09 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:	BAER, UNA		FACILITY NUMBER:	444406107
ADMINISTRATOR:	BAER, UNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 295-3573
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95060
CAPACITY:	14	CENSUS: 0	DATE:	05/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Una Baer		TIME COMPLETED:	02:15 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) Zaid Hakim conducted an Unannounced Annual Random Inspection at the facility today. Upon arrival, LPA observed only the Licensee and her own child engaging in daily activities met with Ms. Una Baer, Licensee. The Licensee is the only adult that resides in the home maintains valid background clearance. The Licensee and her two minor children reside in the home. The days and hours of operation are Monday, Tuesday, Thursday, Friday 7:00am to 7:00pm. Summer days and hours of operation are Tuesday, Wednesday, Thursday, Friday from 7:00am to 7:00pm. LPA observed required postings near the facility entrance; including but not limited to the License to operate, the Emergency Disaster Plan (LIC 610) and Notification of Parents Rights (PUB 393). The facility is licensed for a maximum capacity of 14 and the Licensee stated that she understands capacity options. At the time of the inspection LPA observed that the Licensee is in compliance with capacity and ratio requirements and the approved fire clearance. LPA toured the facility inside and out and observed all indoor and outdoor activity areas. LPA observed door locks and barricade gates securing off limit areas which include three bedrooms and one bathroom. The facility is equipped with functioning smoke detectors, one carbon monoxide detector, one complete first aid kit and at least one 2A10BC fire extinguisher. The Licensee has been informed that fire safety items and fire extinguishers should be maintained at least once every 12 months. Toxic cleaning supplies and other items that pose a danger to children are securely stored in inaccessible locations. The home has sufficient and safe toys, equipment, and supplies. The home was observed to be safe and orderly. The outdoor play area was observed to be free from hazards and equipped with age appropriate toys and equipment. The Licensee stated that there are no weapons or firearms in the home or no fireplaces on the premises. The kitchen and food preparation / service areas were observed to be clean and fully furnished with supplies. The Licensee also stated that she participates in County food programs for the children in care. The licensee stated that there are no bouncers in the home and understands that bouncers may not be used in family home day cares. LPA observed pillows, blankets for napping. LPA observed all furnishings used by children to be safe and in good condition. LPA observed multiple play pens and cribs that are in good condition and are age appropriate. LPA and the Licensee discussed safe sleep for infants in care. 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 CONTINUATION ON FOLLOWING PAGE (PAGE #2 - REPORT DATED 05/08/2019):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid Hakim	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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: BAER, UNA	FACILITY NUMBER: 444406107
	VISIT DATE: 05/08/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 05/08/2019):

LPA advised the Licensee of the new immunization requirement (pertussis, measles, and flu vaccines) for all staff that work directly with the children and the required "Mandated Reporter" training that all staff will be required to complete starting January 1, 2018. LPA referred the Licensee to the Department website to access the training: http://www.mandatedreporterca.com/training/childcare.htm
LPA observed at the time of the inspection the Licensee has completed this required training.

LPA advised that licensing forms and all other information can be found at:
http://www.cdss.ca.gov/inforesources/Child-Care-Licensing

A Notice of Site Visit has been issued and must remain posted for 30 consecutive days.

No Deficiencies were cited as a result of today's inspection.
Exit interview conducted with Ms. Una Baer, Licensee.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid Hakim	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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: BAER, UNA	FACILITY NUMBER: 444406107
	VISIT DATE: 05/08/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 05/08/2019):

The Licensee maintains an accurate roster of enrolled children. LPA reviewed a random sample of child records and each record was observed to be complete and up to date. Emergency disaster drills are documented and conducted as required, last of which being done on 04/2019. LPA confirmed the Licensee maintains current pediatric CPR / First Aid certification with an expiration month of 10/2019. LPA observed that emergency disaster drills are also posted. LPA and the Licensee discussed emergency disaster procedures in the event of a natural or man-made disaster. LPA and the Licensee discussed emergency information regarding the children in care, safety in times of crisis, home surveillance systems in common areas, and emergency supplies maintained in the home. The Licensee provides snacks and meals to the children and stated that food served to children are communicated to parents regularly and the Licensee stated that she is aware of all food allergies or dietary restrictions of the children. LPA observed the outdoor play area in the front yard. The Licensee does take children on walking field trips around the neighborhood and understands children shall be supervised at all times and parents shall be informed of plans or whereabouts beforehand.
The Licensee does not provide transportation to day care children and understands in the event of transportation being provided, that children may not be left in vehicles unattended and seat belt laws must be abided by at all times. The Licensee stated that children are taken for off site field trips and that parent's are notified of mode of transport and activities. The Licensee does not assist any children with Medications at this time. LPA and the Licensee discussed outdoor weather conditions as well such as hot and cold weather in addition to air quality.

A review of staff records during today's inspection indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also reminded The 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. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

CONTINUATION ON FOLLOWING PAGE (PAGE #3 - REPORT DATED 05/08/2019):

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid Hakim	TELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

LIC809 (FAS) - (06/04)

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