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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409051
Report Date: 04/06/2022
Date Signed: 04/06/2022 04:36:07 PM

Document Has Been Signed on 04/06/2022 04:36 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:NASCIMENTO, LUCIARAFACILITY NUMBER:
073409051
ADMINISTRATOR:NASCIMENTO, LUCIARAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 240-1378
CITY:PINOLESTATE: CAZIP CODE:
94564
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 6DATE:
04/06/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Luciara NascimentoTIME COMPLETED:
04:45 PM
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On 04/06/2022 at 2:25pm Licensing Program Analyst (LPA) Diana Campos arrived at the facility and met with licensee Luciara Nascimento for the purpose of conducting a Case Management inspection to inspect a newly installed swing set to be used by daycare children. Present for this inspection was the licensee, two fingerprint cleared assistants, and six children in care consisting of 3 infants and 3 preschool age children. Also present during this inspection were licensee's two minor children.
At 2:30 pm Licensee led LPA to the back yard where the swing was installed. The swing set brand is ALEKO and is described as an "Outdoor Sturdy Child Swing Set with 2 Swings, Trapeze, Glider and Slide". Swing was purchased online through Amazon. Per the licensee the trapeze that originally came with swing set was replaced with a "high back, full bucket toddler swing". Per the licensee she has checked the manufacture guidelines for safety and compatibility for both items prior to making the change. This is a small, light weight swing set that per the manufacturer guidelines is made of alloy steel and plastic with dimensions of 93 x 128.4 x 74.4 inches and a maximum weight recommendation of 600 pounds. The swing is bolted to the ground and does not lift off ground when shaken, however due to the light weight materials swing sways a bit when shaken. Although manufacturer states the swing set is designed for children from 3-12 years old, LPA has advised licensee to use a more conservative age limit of 3-5 years due to the light weight nature of the materials it is made of.
The following has been discussed and agreed upon with the licensee:
Swing set is approved for use by day care children 3-5 yrs old provided licensee follows the manufacturer guidelines at all times and visual supervision by a fully qualified adult assistant is maintained when in use by the day care children. LPA also recommends swing be checked daily for safety prior to use by day care children especially after rain and harsh weather conditions.
No deficiencies cited during todays inspection. Notice of Site Visit provided and must remain posted for 30 days.
Exit interview conducted with licensee Luciara Nascimento.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2022
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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