493009672-5-5-2020-01-CC-YYAG-BPBR29-20200505123759

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 493009672
Report Date: 05/01/2020
Date Signed: 05/05/2020 12:38:04 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:	BOCCALEONI, CINDY FCCH		FACILITY NUMBER:	493009672
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	05/01/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Cindy Bocaleoni		TIME COMPLETED:	03:30 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	A televisit, case management inspection was conducted today by Licensing Program Analyst (LPA) Y. Yang in response to an increase of capacity application received on 03/20/2020. Due to the COVID-19 pandemic, a televisit inspection was conducted in place of an in-person site visit. The licensee is requesting a capacity of 14. The licensee has met the required experience for a large family child care home. The approved fire clearance was received on 04/28/2020 for the requested capacity. A review of staff records on 05/01/2020 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 presently three adults living in the home. During today’s televisit inspection of the home, home and grounds were toured. The licensee was supervising four children. Operating hours are 8:00am to 5:00pm, Mon–Fri. The garage, laundry room, and bedroom 3 are off-limits. The off-limits areas are made inaccessible with child gates, door knob covers, and/or latches. The living room, kitchen, bedroom one, bedroom 2, hall bathroom, and play room are on-limits. The licensee understands that off-limits areas will need to be made inaccessible at all times during child care hours. The children will use the home's backyard and front yard as the outdoor play areas and they are fully fenced. There are no bodies of water on the premises. The licensee stated there are no poisons stored on the premises and none were observed. Ratios for a large family child care home were reviewed. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) were stored out of the reach of children. There is a working smoke detector, carbon monoxide detector, and charged fire extinguisher rated 2A:10B:C in the home. The licensee stated there are no firearms and/or other dangerous weapons in the home. (Continued on LIC 809-C)

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang Yang	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2020

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

FACILITY NAME: BOCCALEONI, CINDY FCCH	FACILITY NUMBER: 493009672
	VISIT DATE: 05/01/2020

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The licensee is currently not providing Incidental Medical Services – IMS. 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 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, as well as the AAP Guide to Safe Sleep Practices were discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.

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

The increase of capacity is granted effective today's date.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang Yang	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2020

LIC809 (FAS) - (06/04)

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