198400406-7-22-2021-54-CC-AMOY-C56SC9-20210722134510

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400406
Report Date: 07/22/2021
Date Signed: 07/22/2021 01:45:23 PM

Document Has Been Signed on 07/22/2021 01:45 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	OLIVER FAMILY CHILD CARE		FACILITY NUMBER:	198400406
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	07/22/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Mia Oliver, Applicant		TIME COMPLETED:	01:45 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted a pre-licensing inspection for the above address. LPA met with Mia Oliver (Applicant) who guided LPA on tour of the facility. Individuals residing in the home were discussed and noted. Per Applicant, hours of operation will be Monday through Friday, 6:30am to 6:00pm. Applicant states that she will care for children Infants-12 years of age.
This is a one-story home which consists of 3 bedrooms, 1 bathroom, living room, dining room, kitchen, laundry area, office, front and backyards and detached garage space located in back yard. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

Areas used by children include: Living room (main childcare area), dining room, bathroom, office and back yard.

Areas off limits include: Bedrooms, kitchen, laundry area (located in kitchen), front yard, and detached garage. Off limit areas are made inaccessible by safety door knobs for the bedrooms, safety gates blocking entrance to the kitchen.

Knives and other sharp utensils are in. Cleaning products were located in locked cabinet under the sink in kitchen and in the laundry room. The home is clean and orderly, there are outlet covers throughout the home. Smoke detectors and carbon monoxide detector were observed, tested and found to be operable. The homes fans and portable oscillating heaters for safety and comfort. Per applicant, there are no poisons in the home. Applicant was advised that poisons need to be locked.

Applicant has current Pediatric First Aid and CPR Exp: 06/9/23. Applicant has proof of immunization against pertussis and measles. Proof of Mandated Reporter Training on 06/21. Applicant states she will provide food for children in care. Applicant was advised to properly label and store children's food if brought from home. LPA observed age appropriate toys. Page 1

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: OLIVER FAMILY CHILD CARE	FACILITY NUMBER: 198400406
	VISIT DATE: 07/22/2021

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Applicant will provide a play yard for each infant that is enrolled. LPA observed a play yard and cots for napping. Per applicant, children will nap on cots and infants will sleep in playpens in the living room or dining where they will be supervised at all times.

LPA informed Applicant of the new Safe Sleep regulation and provided PIN 20-24-CCP for when Applicant is ready to enroll infants. LPA provided the applicant with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. Applicant was also advised children shall not be left in parked vehicles at any time.

The required (2A10BC) fire extinguisher was observed in the living room by the kitchen. However, the receipt was not found. First Aid and emergency kits are available in the living. Per Applicant, there are no weapons or firearms in the facility, none were observed by LPA. Applicant has 3 small dogs observed to be in a gated area in the back yard. Per licensee, the pets will be kept separate form the childcare children.

Per applicant, the back yard and the cemented driveway leading to the backyard will be used as outdoor play area. The backyard and driveway are enclosed with shade and cushioned play area. LPA observed that the cemented driveway Safe and age appropriate toys were available. LPA observed closed and latched gates at both sides of the yard leading to the front of the home. There are no bodies of water on the premises.

The following was discussed with the applicant:

· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification, TB clearance, immunization, and a valid criminal record clearance associated to the facility license.
· Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. The family day care home shall maintain documentation...in the person’s personnel record that is maintained by the family day care home.
Report Continues - Page 2 of 4

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: OLIVER FAMILY CHILD CARE	FACILITY NUMBER: 198400406
	VISIT DATE: 07/22/2021

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A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License shall be terminated.
· The fire extinguisher type 2A10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should checked and batteries replaced as needed.
· Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
· Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
· Fire and safety drills must be performed every six months and documented for review by the Department.
· Smoking is prohibited in a family child care home.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
· Saucer chairs, bouncers, walkers, or any similar items are prohibited.
· All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are required to be posted.

Incidental Medical Services (IMS) policy was 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

LPA reviewed Forms/Records to Keep in Your Family Child Care Home (LIC 311D) with the applicant. LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: https://www.cdss.ca.gov/inforesources/forms-brochures

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: OLIVER FAMILY CHILD CARE	FACILITY NUMBER: 198400406
	VISIT DATE: 07/22/2021

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COVID-19 Technical Assistance : LPA sent COVID-19 resources and self-assessment prior to visit. LPA discussed self-assessment and answered question regarding COVID-19 procedures. Per Applicant, parents will drop off children at the front entrance. LPA observed a sign in/out table at the facility entrance. LPA observed hand sanitizer, masks and gloves, thermometer and COVID-19 signs. Per Applicant they will ask screening questions and take children's temperatures daily. Applicant will notify the parents in writing of COVID-19 specific exclusion criteria (Applicant provided with PIN 20-06-CCP) and return policies.
Per applicant children and staff will wear face coverings in accordance to Department of Health Guidelines. Applicant will ensure children are properly hand washing throughout the day as recommended. LPA observed soap and paper towels in the bathroom as well as hand washing poster for children. Applicant has a supply of cleaning and sanitizing products. Per Applicant high touched areas will be cleaned throughout the day as needed. LPA observed multiple tables in the living room to be used for activities and meals. Tables were spaced 6 feet apart following social distancing guidelines. LPA observed space in the main care area to socially distance children during nap time.

If a child becomes ill, Applicant will utilize the office area as an isolation area until child is picked up. LPA observed an outdoor area where child have space to play. Per Applicant they will utilize the outdoor area for ventilation and meals when weather allows. A small family child care can have no more than eight children at one time.

Per Applicant, they are familiar with the Child Care Licensing website: www.ccld.ca.gov and will access forms, regulations and quarterly updates.

Based on the LPA’s observations, the following corrections are needed in order to complete the Application for Small Family Child Care Home:

-Applicant will make the kitchen inaccessible to children.
-Provide proof of purchase of 2A10BC Fire Extinguisher

After further review by the department, Applicant will be notified if/when License is granted. Once licensed, the applicant is required to adhere to the terms and limitation as stated on the license.
Exit interview was conducted with Mia Oliver,

End of Report

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

LIC809 (FAS) - (06/04)

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