566215952-5-28-2020-17-CC-RGUL-BQ2N8S-20200528101448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215952
Report Date: 05/28/2020
Date Signed: 05/28/2020 10:15:09 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	VALDES FCC AKA JOJOS PLAYHOUSE DAY CARE		FACILITY NUMBER:	566215952
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	05/28/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Joanna Valdes		TIME COMPLETED:	10:15 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	On 5/28/2020 at 9:30am, Licensing Program Analyst (LPA) Ruth Gull conducted a PRE-LICENSING tele-video inspection with Licensee Joanna Valdes (due to the COVID-19 State of Emergency). This is a change of location (current facility #566214386). LPA Gull asked and Licensee denied having anyone in the home who exhibited any symptoms associated, or had been exposed to a person known to have been diagnosed, or was infected with COVID -19. A virtual tour of the home was made both inside and outside.This is a two story home, the upstairs is off-limits and the bottom of the staircase is barricaded with a safety gate. The Licensee will use the living room, dining room, family room, kitchen and hall bathroom for the day care. The fireplace in the family room is screened. The attached garage is off-limits/child proof door knob. LPA did not observe any toxins/hazardous items accessible to children. The regulation fire extinguisher was serviced on 05/04/20. Licensee is reminded to either service or purchase a regulation fire extinguisher every year. The smoke detector and carbon monoxide detector were tested and observed to be functioning. Licensee will use the backyard for the day care and it is completely enclosed by fences with gates. Licensee's Pediatric 1st Aid/CPR certificates (American Red Cross) expire 05/15/22. Licensee states that there are no guns/weapons on the premises. LPA did not observe any bodies of water. On 5/26/20, Licensee had submitted proof of property ownership document. Licensee states that she has liability insurance. CONTINUED ON LIC 809-C

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Ruth Gull	TELEPHONE: (805) 895-4073
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2020

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VALDES FCC AKA JOJOS PLAYHOUSE DAY CARE	FACILITY NUMBER: 566215952
	VISIT DATE: 05/28/2020

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. 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.

LPA reviewed required forms to be kept in the children's file, required forms to be posted and forms that needs to be maintained at the FCCH and capacity requirements. LPA also discussed information about Sudden Infant Death Syndrome/Safe sleep and Effects of Lead Exposure pamphlet (which needs to be provided to each family). Licensee was previously e-mailed all of the forms and information discussed above.

Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov. Licensee was also reminded to keep checking the website for updates and resources regarding the COVID-19 State of Emergency. Also, Licensee was reminded that baby walkers, jumpers, bouncers, exersaucers, or any similar article are not permitted on the premises during day care hours.

The home will be licensed effective 06/01/20.

Exit interview was conducted with Licensee Valdes via tele-video. This report will be sent to the Licensee via email with a read receipt or confirmation of receipt of email, which will act as the Licensee's signature.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Ruth Gull	TELEPHONE: (805) 895-4073
LICENSING EVALUATOR SIGNATURE:	DATE: 05/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2020

LIC809 (FAS) - (06/04)

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