503911151-1-28-2020-04-CC-NLOI-BL9QL8-20200128111531

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503911151
Report Date: 01/28/2020
Date Signed: 01/28/2020 11:15:42 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	BOYLE, LAURIE FAMILY CHILD CARE		FACILITY NUMBER:	503911151
ADMINISTRATOR:	BOYLE, LAURIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 248-7901
CITY:	MODESTO	STATE: CA	ZIP CODE:	95357
CAPACITY:	14	CENSUS: 0	DATE:	01/28/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Laurie Boyle		TIME COMPLETED:	11:30 AM

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), Norma Lomeli met with Applicant, Laurie Boyle for a pre-licensing, change of location and capacity increase inspection. Applicant, her Roommate, Adriana Lopez, who will also be applicant’s assistant and two minor children reside in the home. Applicant completed the CPR/First Aid through Pediatric Plus with EMSA certified stickers and expires on 3/6/2021. Applicant’s assistant completed CPR and First Aid through American Red Cross and expires on 12/7/2021. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance. Fire clearance was granted on January 24, 2020. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: Fire clearance was received on January 27, 2020. Fire alarm is located on the left hand side of the wall as you enter the home’s doorway. This is a single story, four bedrooms and two bathrooms home and children will have access to the living room, kitchen, bedroom #1 and hallway bathroom. Off-limits rooms are made inaccessible by use of key locks. LPA observed safe toys, and books for the children. Children will nap in the living room. Infants nap in the Applicant understands she is to supervise children at all times. Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. (Continued on LIC809-C):

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: BOYLE, LAURIE FAMILY CHILD CARE	FACILITY NUMBER: 503911151
	VISIT DATE: 01/28/2020

NARRATIVE

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Preventative Health and Safety class was completed on December 7, 2019.
Knives are stored inside a top kitchen cabinet that is located above the range hood. Medications are stored in a locked storage box that is kept on top of the refrigerator.
Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
There are no bodies of water in the home. Backyard neighbor has an above ground pool and neighbor on the north side has an underground pool. Applicant states that she will have visual supervision of the children when playing outdoors.
Applicant states there are no pets in the home or on the premises.
Applicant states there are no weapons, firearms or ammunition in the home or premises.
Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
Applicant states she will not be transporting day care children. Applicant understands that she must have proper restraints and/or car seats for all the children under her care when transporting children.
Fenced backyard has a cemented area for the children to play.
SB 792 immunizations verified and on file.
Applicant completed the Mandated Reporter Training on May 7, 2018. Applicant’s assistant completed the training on September 16, 2019.
LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.

(Continued on LIC809-C):

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: BOYLE, LAURIE FAMILY CHILD CARE	FACILITY NUMBER: 503911151
	VISIT DATE: 01/28/2020

NARRATIVE

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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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. She is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Sunday from 5:30 AM to 7:30 PM and as arranged. No overnight care will be provided.

Licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended effective January 29, 2020.

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

LIC809 (FAS) - (06/04)

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