073408977-4-25-2023-02-CC-ACUY-CR8TUL-20230425150230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408977
Report Date: 04/25/2023
Date Signed: 04/25/2023 03:03:07 PM

Document Has Been Signed on 04/25/2023 03:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	GALVEZ, VERONICA		FACILITY NUMBER:	073408977
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 6	DATE:	04/25/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Veronica Galvez		TIME COMPLETED:	03:00 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	On 04/25/2023 at 1:00 PM Licensing Program Analyst (LPA), A. Curry arrived at the home and conducted an announced Increase of Capacity inspection. LPA met with licensee, Veronica Galvez, who submitted an application for a Large Family Child Care Home. Fire clearance was received on 04/05/2023. Also present for the inspection is the applicant’s fingerprint cleared daughter Priscilla Galvez and 6 preschool age children. The hours of operation for the family child care home will be Monday-Friday 6:00am-6:00pm. A tour of the home was completed with the licensee to conduct a health and safety inspection. The home is single-story and consist of 3 bedrooms, 2 bathrooms, living room, kitchen, fenced backyard, and garage. The children will use the bathroom in the hallway, living room, bedroom #1, Bedroom #3, and backyard . Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. The off-limits areas are bedroom #2, bathroom located in room #2, and the garage, which will be inaccessible by closed and/or locked doors and visual supervision. The Isolation area will be in room #1. The licensee was advised that any area that will be changed to an on limit area will need to be inspected by Licensing prior to use. There were safe toys, play equipment, and materials observed for children. LPA did not observe any bodies of water, toxins, medications or hazardous items that would be accessible to children. The licensee stated there are no firearms on the premises. The home is equipped with a fully charged 2A10BC fire extinguisher, working smoke alarm, working carbon monoxide detector, telephone, and first aid supplies. The applicant completed the required preventative health and safety training, which includes 1 hour of nutrition, the required lead poisoning prevention training, and has current CPR and First Aid training which expires on August 28, 2023 respectively. Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. 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

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023

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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: GALVEZ, VERONICA	FACILITY NUMBER: 073408977
	VISIT DATE: 04/25/2023

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This home will be licensed as a Large Family Child Care Home effective today, 4/25/2023. An exit interview was conducted, appeal rights were given, and report was reviewed with licensee Veronica Galvez.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023

LIC809 (FAS) - (06/04)

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