493008276-8-6-2019-01-CC-ASTR-BESSNA-20190806140112

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 493008276
Report Date: 08/06/2019
Date Signed: 08/06/2019 02:01:20 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME:	ARISTIZABAL, ALETA FCCH		FACILITY NUMBER:	493008276
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 2	DATE:	08/06/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Aleta Aristizabal		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	An annual random inspection was made to the facility by Licensing Program Analyst (LPA), Amy Strother. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently six adults living in the home. During today’s inspection the home and grounds were toured. The licensee and two assistants were supervising two children, and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The facility’s operating hours are 7:00 a.m. to 5:30 p.m., Mon–Fri. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the garage, made off limits by a locking latch on the door, and the master bedroom made inaccessible by a child safety gate. During the inspection, the licensee stated that she has converted a portion of the garage into a bedroom and would like to use it as a nap room. LPA advised the licensee that the cleaning products and paints in the laundry area of the garage will need to be made inaccessible before the bedroom area of the garage can be added to the on limits area of the home. Once the licensee has made the cleaning products and paint inaccessible, a photo of the area and an updated LIC999A Floor Plan will be submitted to the department and the garage/bedroom can be used during child care hours. The home was observed to be clean and orderly, and was at a comfortable indoor temperature. There were safe toys and equipment available for children. The licensee stated there is a working telephone in the home. The licensee’s pediatric CPR and First Aid certifications were reviewed, and expire on 11/2019. Items which could pose a danger to children (such as detergents, cleaning compounds, medications, etc.) were observed to be stored out of the reach of children. The licensee stated that there are no poisons stored on the premises and none were observed during today's inspection. The fireplace has been made inaccessible with a child safety gate. The LPA observed a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The roster of children in care was reviewed and was current. Continue on LIC809-C

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019

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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: ARISTIZABAL, ALETA FCCH	FACILITY NUMBER: 493008276
	VISIT DATE: 08/06/2019

NARRATIVE

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The licensee has conducted an emergency drill within the past six months, last drill was documented August 2019. The licensee stated there are no firearms and/or other dangerous weapons in the home and none were observed during today's inspection. The children use the backyard as the outdoor play area and it is not fully fenced. The licensee understands that while using the outdoor play area, the children need to be supervised at all times. The licensee stated that the area that is not currently fenced is being worked on during off hours and will be fully fenced again in the future. There were no pools or other bodies of water observed. Two children's records were reviewed at 12:25 p.m.; current immunizations and Notification of Parent’s Rights forms were on file. The licensee is not currently providing Incidental Medical Services (IMS) to children in care. The licensee stated that none of the children in care require IMS at this time. The Incidental Medical Services (IMS) policy was discussed with the licensee. 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 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, www.ada.gov/childqanda.htm. This report, the AAP Guide to Safe Sleep Practices,The Effects of Lead Exposure brochures, and the Community Care Licensing website were reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

There were no Title 22 deficiencies cited during today's inspection.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019

LIC809 (FAS) - (06/04)

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