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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005627
Report Date: 10/05/2022
Date Signed: 10/05/2022 11:48:35 AM

Document Has Been Signed on 10/05/2022 11:48 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:DEMSKI, AUDREY N.FACILITY NUMBER:
214005627
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
10/05/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Audrey DemskiTIME COMPLETED:
11:46 AM
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On 10/05/2022, Licensing Program Analysts (LPA), Hanson Leong & Maria Olguin-Leon, made an announced case management visit to the Audrey Demski facility. Audrey Demski, the licensee, has requested a departmental visit because she wants to use her backyard for her day-care. The LPAs were granted entry by the licensee. The LPAs explained the purpose of the visit to the licensee. Guardian, the department's system for conducting background checks, has confirmed that all the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The LPAs observed the licensee supervising three infants. Children's capacity and ratio requirements were observed to be in compliance.

The LPAs and the licensee carried out a thorough inspection of the backyard to look for any potential health and safety concerns. The area that is set aside for the backyard is well kept and clean. Every item of furniture, toy, and piece of equipment has been inspected to ensure that it is appropriate for the age range and in good shape. The LPAs made the observation that the playground equipment and outdoor furnishings are in very good shape. The outdoor play structures are surrounded by grass, which can cushion any falls that may occur.

The LPAs will provide approval for the backyard to become a component of the licensed day care facility. The backyard will take affect on 10/05/2022.

A copy of this report, and the “Notice of Site Visit,” were given to the licensee. A “Notice of Site Visit” must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Licensee, Audrey Demski.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2022
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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