214005609-1-5-2022-05-CC-HKAR-CADUGQ-20220105143444

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005609
Report Date: 01/05/2022
Date Signed: 01/05/2022 02:34:52 PM

Document Has Been Signed on 01/05/2022 02:34 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	LONCHAR, MAYA		FACILITY NUMBER:	214005609
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	01/05/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Maya Lonchar		TIME COMPLETED:	03:15 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 01/05/22 at 12:45PM., Licensing Program Analyst (LPA), Kaur met with Applicant, Maya Lonchar for a scheduled change of location Pre licensing inspection at the facility. COVID-19 prevention and mitigation measures were also reviewed during inspection. Present was the applicant, applicant’s one child. Per applicant, child present is her daughter. Applicant rents home with her daughter. Home is a two story house 5 bedrooms, 3 bathrooms. Day and hours of operation are: Monday – Friday 8:00A.M. – 5:30 P.M. Daycare Area: Playroom (Living Room), Bathroom #1 and Hallway (Pass Through Only), bedroom downstairs, backyard. Off-limit Area: Upstairs bedrooms, ground floor Kitchen, 2nd living room and second dining room LPA inspected entire home with applicant for health and safety hazards. At 12:50 P.M., LPA observed the following: Day-care was clean, orderly with a variety of age- appropriate toys and blocks. Furniture and playthings inspected were in good condition. Playroom had child size tables and chairs for snack and activities. LPA observed drawers for storage of children’s belongings. Child safety gates had been installed for children to get access from off limit areas. Fireplace was properly barricaded. Applicant installed large area rugs in playroom for added safety. Napping supplies, stored in playroom, including cleanable napping mats and two play pens. Bathroom #1 was in operating condition with adequate supplies. All accessible outlets have been properly covered. Cabinets and drawers in kitchen were made inaccessible. Detergents, cleaning compounds and other items which could pose a danger, were stored in off-limit area. Home was the proper temperature with adequate ventilation and natural lighting. Facility has functioning cell phone, smoke detector, carbon monoxide detector, and one fully charged fire extinguishers (2A:10BC) located in kitchen. The home does not have any pools, jacuzzis, fish pods or any other bodies of water. (REFER TO 809-C, FOR CONT.)

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LONCHAR, MAYA	FACILITY NUMBER: 214005609
	VISIT DATE: 01/05/2022

NARRATIVE

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Per applicant, there are no guns or weapons in the home. Isolation area for an ill child will be in the second dining room. Applicant was informed that the Department must be notified prior to the use of any off-limits area. Applicant’s CPR/ first aid certification is current and expires on: 01/05/2024. Applicant’s Mandated Reporter Training is current and expires on: 05/27/23. LPA and the applicant discussed licensing regulations and the capacity requirements. Any children under 10 years of age will be counted in the capacity. Applicant stated she plans to provide a daily snack and lunch. Applicant was advised that all food containers brought from home must be properly stored and labelled. Applicant understands emergency disaster drills are to be conducted every six months and documented. Applicant understands that baby walkers, bouncers, and excersaucers are not allowed. Smoking is prohibited inside a Family Childcare Home.

Applicant was informed that all adults, 18 years and older who live in the home or assist with children, must have their criminal record clearance and association prior to having contact with day-care children. For background clearance transfers, applicant can submit the LIC 9182 with copy of CA DL or CA ID. Failure to comply could result in an immediate civil penalty of $100.00 per day. Applicant was reminded that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility, unless he or she has been immunized for influenza, pertussis and measles or qualifies for an exemption pursuant to Health and Safety Code 1596.7995 and 1597.662.

Incidental Medical Services (IMS) 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 Americans with Disabilities Act (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: www.ada.gov/childqanda.htm.
Mandated Reporter Training is available on the CCLD website. Training must be completed every two years by the applicant and all facility staff. Training can be taken online: www.mandaterreporterca.com. (REFER TO 809-C, FOR CONT.)

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LONCHAR, MAYA	FACILITY NUMBER: 214005609
	VISIT DATE: 01/05/2022

NARRATIVE

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Applicant was informed about the Provider Information Notices located on the CCLD website. Safe Sleep handout was discussed. Applicant understands Individual Safe Sleep Plans (LIC9227) shall be completed for infants up to 12 months of age and maintained in the infant’s file.

Applicant can also email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

During inspection applicant submitted: Preventive Health and Safety Practices Certificate, Proof of Child Care Orientation, LIC9217, LIC508, Proof of immunization, COVID-19 Self-Assessment.

Licensure will be recommended as of today 01/05/2022.

The report was reviewed and signed by the Licensee, Maya Lonchar. Today's report, 01/05/2022, will be sent to the Licensee email at lilysplaygroundofmarin@gmail.com by the close of business on 01/05/2022. Confirmation of receipt is required.

Copy of this report was provided to the applicant. This report will be kept in the facility file and will be made available for public review upon request. Desk Duty Line is available Monday through Friday between 8 AM - 5 PM at (650) 266-8800.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Harsimran Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2022

LIC809 (FAS) - (06/04)

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