103911694-1-19-2022-04-CC-RMAS-CATRDR-20220119115623

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103911694
Report Date: 01/19/2022
Date Signed: 01/19/2022 11:56:28 AM

Document Has Been Signed on 01/19/2022 11:56 AM - 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	DAVILA, GABRIELA FAMILY CHILD CARE		FACILITY NUMBER:	103911694
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	01/19/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Gabriela Davila		TIME COMPLETED:	12:00 PM

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On 01/19/2022 a planned Pre-licensing inspection was made today by Licensing Program Analyst (LPA) Rene Mancinas, who met with Applicant, Gabriela Davila. A tour of the home, inside and outside, as shown on the facility sketch was done. This is a single-story home. The areas of the home that day-care children will have access to are the living room, kitchen, dining room, hallway bathroom, two bedrooms, and the back patio area. The remainder of the home is off limits. Applicant and husband are the only adults that reside in the home. The LIS 536 was signed indicating that the adults living in the home and/or providing care and supervision to children are background cleared. LPA observed safe indoor play areas, child safety plugs in unused electrical outlets, were all observed. Facility has working smoke detectors, carbon monoxide detectors and first aid kit are operable and in place. There no firearms or ammunition at this home. There is an in-ground swimming pool at this home. CPR, first aid training, and health and safety training are current and expiring 07/31/2023. Child Abuse Mandated Reporter Training Completed on 09/29/2021. Postings, forms, and licensing information were provided and discussed. LPA discussed the practice of fire and disaster drills at least every 6 months and to document the date, time and number of children present. There are no pets at this home.

Incidental Medical Services (IMS) policy were discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

(Continued on 809-C)

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Rene Mancinas
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2022

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: DAVILA, GABRIELA FAMILY CHILD CARE	FACILITY NUMBER: 103911694
	VISIT DATE: 01/19/2022

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Applicant 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, 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 applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed applicants 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.

The following items are pending and/or need to be corrected prior to licensure for a small Family Child Care Home, capacity of eight children * ages under 18 years* to be granted. Planned hours of operation are Monday through Friday from 05:00AM - 05:00PM, and as arranged. License effective date to be determined based upon below corrections completed.

1. Applicant is to install a pool fencing which meets fencing regulation requirements.

2. Applicant is to install safety devices (e.g. safety latches, door knob spinners) to prevent children from access to inaccessible rooms and cabinets with hazardous items.

3. Applicant needs to purchase a 2:A -10:BC fire extinguisher.

Exit interview conducted and report was reviewed with the applicants.
This report shall be made available to the public upon request.
To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Rene Mancinas
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2022

LIC809 (FAS) - (06/04)

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