515407803-11-2-2020-13-CC-MMAZ-BUYSJC-20201102125453

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 515407803
Report Date: 10/29/2020
Date Signed: 11/02/2020 12:55:34 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	VASQUEZ-MELENDREZ, MARIA FAMILY CHILD CARE HOME		FACILITY NUMBER:	515407803
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	10/29/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Maria Vasques-Melendrez		TIME COMPLETED:	03:31 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 pre-licensing tele-inspection was conducted today by LPA Mikah Martinez by Facetime. The applicant is requesting a license for a capacity of 8. Services will be provided Mon-Thur 7:30am-5:30pm. The residence is a three bedroom/ two bath home. There are two adults and two children living in the home. The applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. All minors residing in the home must be fingerprinted within 30 days of reaching their 18th birthday and obtain a TB clearance. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance. Children will have access to the entire home except a bedroom and the master bedroom of the home. The master bedroom and childs bedroom are inaccessible with a door knob cover. The garage has been converted to the main area use for childcare. The restroom down the hall will be used for childcare. The children will enter the home through the front door of the house. Poisons are stored in the outside shed. The sharp knives, cleaning supplies, medicines, are stored out of the reach of children. There is a fire place in the home however it is not in use and needs to be closed in some fashion. The children in care will have access to age appropriate toys and equipment. The children will use the back yard that is fully fenced as outdoor play. The home is equipped with a working smoke detector and carbon monoxide detector fire extinguisher rated at least 2A10BC was observed in the home. The licensee does have a dog in the home and was advised that all water bowls and food should be out of reach of children. The applicant may intend to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah Martinez	TELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2020

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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: VASQUEZ-MELENDREZ, MARIA FAMILY CHILD CARE HOME	FACILITY NUMBER: 515407803
	VISIT DATE: 10/29/2020

NARRATIVE

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The applicant may obtain liability insurance and will provide the department with a copy of the insurance once decided. Parent's rights poster will be posted. Emergency drills must be conducted at least once every six months and the date documented. Children's records to be maintained were reviewed. The roster is to remain current at all times. Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report within seven days. The applicant will remain current on Pediatric CPR and First Aid. The applicant shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current Pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged. Smoking is prohibited at all times in those areas where childcare is provided.

The applicant understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website. http://ccld.ca.gov/. Megan's Law web site was provided (http://www.meganslaw.ca.gov). The licensee understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice. This report was reviewed and discussed with the applicant. Guide to Safe Sleeping Practices pamphlet was provided and discussed.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

The following items need to be sent to the office before being licensed
1. Confirmation that PHP course has been completed
2. Photo of mandatory postings present where parents/guardians can view

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah Martinez	TELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2020

LIC809 (FAS) - (06/04)

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