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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409035
Report Date: 06/17/2022
Date Signed: 06/17/2022 01:23:30 PM

Document Has Been Signed on 06/17/2022 01:23 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:PULVER, DIANNAFACILITY NUMBER:
073409035
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
06/17/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Dianna PulverTIME COMPLETED:
11:30 AM
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On 06/17/22 at 9:00 AM Licensing Program Analyst (LPA), Christina Watts conducted a Case Management Inspection (Change of Capacity) at Dianna Pulver's family day care and met with Licensee, Dianna. LPA explained the purpose of today's inspection. Licensee currently is licensed as a Small Family Child Care Home with a capacity of eight (8). During today's inspection, there were no children in care due to facility currently is closed due to 2 positive cases of COVID-19. Facility closed day care starting from today, Friday, June 17, 2022. Licensee states she has contact licensing to report 2 COVID cases. Facility will reopen on Wednesday June 22, 2022. Days and hours of operation will be Monday through Friday from 6:30 AM - 6:00 PM. She will be caring for only school age children with 1 infant whose parent works in the facility. Licensee is providing care for children from June 13, 2022 to July 29, 2022 as a summer camp. Licensee will contact licensing if she decides to open for care in the school year.
There are total of seven adults and two children residing in the home: Licensee, her spouse, licensee 3 adult children, licensee son in law and licensee 2 grandchildren ages 8 and 7, as well as a friend of licensee who are all fingerprint cleared. Licensee completed her Pediatric CPR/First Aid and Mandated Reporter. Licensee has documentation maintained for Measles, Pertussis Immunization's, Influenza Opt-Out statement for the current flu season. There is a working telephone in the home. Fire clearance request was approved 05/18/2022 by ECC Fire Protection Department.
INDOOR SPACE: LPAs inspected the indoor space of the home. The home is two stories consisting of 3 bedrooms, 2.5 bathrooms, kitchen, dining area, living room, upstairs loft, attached garage and detached garage. The home is sanitary, safe and orderly, with heating and ventilation for safety and comfort.
IN-USE AREAS: Living room, downstairs bathroom, half bathroom, and large yard that included treehouse, a pool, and a deck.
OFF LIMIT AREAS: Entire second floor which contains 1 bedroom, 1 bathroom and upstairs loft, attached garage, detach garage.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/17/2022
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: PULVER, DIANNA
FACILITY NUMBER: 073409035
VISIT DATE: 06/17/2022
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There is a fireplace in the living room which is gas powered. Switch for fireplace is inaccessible for children in care. LPA observed 2 fully charged 2A10BC fire extinguisher, working smoke detector and , Medicines, cleaning products, sharp objects are stored inaccessible to children. Door access to the attached garage from the kitchen is locked. LPA reminded that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. Stairs to the second level have child gates on the bottom of stairs. There are 3 arms in the home. They are locked in safe in the closet in the upstairs loft. There is no ammunition in the home.
OUTDOOR SPACE: LPA toured the outdoor area and observed fenced side yard and backyard. Yard has pool, large wooden deck, treehouse, detached garage, with another gated area on the far left side of the yard. Behind the house is a canal. Fences are high enough and canal is completely inaccessible. Also in the yard is tight rope and zipline. LPA reminded licensee to installed mats below zipline and tight rope to absorb a fall. LPA also instructed licensee to install a safe structure for child to access zipline. 100% supervision is required for both zipline and tight rope. Treehouse was also inspected during facility inspection. Licensee wants to use pool as in use area. LPA reminded licensee to have 100% supervision while children are in pool. Children are to have life vest while in pool.
Door access to attached garage from side yard is locked.
LPA discussed and reminded Applicant day care needs to be operated within the limitations and capacity of a Large Family Child Care Home with regards to ratios and that Licensee has to be present in the day care for 80% of the operation hours. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.
For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Effective as of 06/17/ 2022, Licensee Dianna Pulver capacity increase application has been approved.

There are no deficiencies cited today. The report will remain on file for three years. Notice of Site was given. At 11:30 AM Exit interview was conducted with Licensee Dianna and she signed the report acknowledging receipts of documents.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
LIC809 (FAS) - (06/04)
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