214005692-7-3-2024-05-CC-JTSE-D6TT8K-20240703143029

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005692
Report Date: 07/03/2024
Date Signed: 07/03/2024 02:30:41 PM

Document Has Been Signed on 07/03/2024 02:30 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	ARANTES DA SILVIERA, SOLANGE		FACILITY NUMBER:	214005692
ADMINISTRATOR/ DIRECTOR:	ARANTES DA SILVEIRA, SOLAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 407-2020
CITY:	MILL VALLEY	STATE: CA	ZIP CODE:	94941
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	07/03/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:10 PM
MET WITH:	Applicant, Solange Arantes Da Silveira		TIME VISIT/ INSPECTION COMPLETED:	02:45 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 7/3/2024, at approximately 1:10PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an announced prelicensing visit at 405 Ash Street, Mill Valley, for a change of location. LPA met with Applicant, Solange Arantes da Silveira. LPA explained the purpose of the visit. Present during the visit was Applicant and no children in care. Applicant is the licensee of facility number 214005520. Intended Day Care Areas: Bonus Room (School Room), Bedroom #3, Front Yard and Backyard (Deck and Patio). Off-limits Areas: Bedrooms #1 and #2, Office, Living Room, Dining Room, Bathroom #1, Bathroom #2 (located in Bedroom #2), Breakfast Area, Kitchen, Laundry Room, Carport (in Front Yard) and Storage Room (located at side of home). LPA inspected the home for any health or safety hazards. There is a fully charged 2A10BC fire extinguisher present. There are operational combination smoke and carbon monoxide detectors. There is an operational fire alarm in the home. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care. Applicant has acquired fire clearance. The Bonus Room (School Room) is clean and free of debris. Per Applicant, day care supplies and materials are in the process of being moved into the new location. LPA requested that photos of the furnished Bonus Room be submitted via email once Applicant is finished moving in. Applicant agreed. LPA observed Bedroom #3 to contain a refrigerator. Bedroom #3 will be used as a napping area. LPA discussed adding childproof locks to the refrigerator. Applicant stated that they understood. Per Applicant, mats and sheets will be provided by the facility. Children will bring blankets from home, and they will be kept at the facility. The facility will clean sheets weekly or as needed. Continued on Page Two

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024

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

FACILITY NAME: ARANTES DA SILVIERA, SOLANGE	FACILITY NUMBER: 214005692
	VISIT DATE: 07/03/2024

NARRATIVE

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Page Two
The Backyard was observed to have a Deck and a Patio. Applicant stated that there would be plants to put on the Deck to act as barriers. Applicant stated that gates would be installed to act as railings. Applicant intends to install artificial turf to act as resilient padding in the future. The Front Yard is intended for use for planting activities.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Applicant has acquired a signed Property Owner/Landlord Consent Form (LIC9149).

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (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 with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

Continued on Page Three

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024

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

FACILITY NAME: ARANTES DA SILVIERA, SOLANGE	FACILITY NUMBER: 214005692
	VISIT DATE: 07/03/2024

NARRATIVE

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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-and-resources/safe-sleep, as an additional resource. LPA also informed applicant 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.

On this date, 7/3/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with the applicant, Solange Arantes da Silveira.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/ subscribe and select the Child Care option to receive email communication.

Prior to licensure, applicant shall provide photos of all the fully furnished daycare areas.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024

LIC809 (FAS) - (06/04)

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