304313952-11-2-2021-06-CC-KDEI-C8DRFH-20211102125911

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313952
Report Date: 11/02/2021
Date Signed: 11/02/2021 12:59:35 PM

Document Has Been Signed on 11/02/2021 12:59 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	NAVARRO, PATRICIA		FACILITY NUMBER:	304313952
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	11/02/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Licensee Ms. Navarro, Patricia & Mr. Navarro Jose		TIME COMPLETED:	01:15 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	Licensing Program Analyst (LPA) Desai, Ketki conducted an announced Pre-Licensing inspection for Relocation at the Family Child care home. On today's inspection present was the Licensee's son, Navarro, Jose who assisted his mom translating into Spanish from English. LPA met with Licensee Ms. Navarro, Patricia who guided the LPA for the tour of the new home. There were no children present at the time of inspection. A review of the Facility Personnel Report Summary indicates all adults, residing in the home who required caregiver background check clearances are cleared and transferred. Licensee is relocating and shall continue with the Small Family Child care home license. Per Licensee, operation hours will be Monday to Friday, 5:00AM to 12:00 AM. Licensee states that she will care for children 3 weeks to School age children (12). Licensee was made aware that the same child cannot be in care for 24 hours at a time. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single-story home that consists of 3 bedrooms, Office room, 2 restrooms, (Day care room) living room, kitchen with dining, laundry room, front yard, side walkway, backyard and a garage. There is no stairway or fireplace in the home. Office room is adjoining the bedroom on the left hand side of the passage and this office has direct access to the garage, designated as off- limit area to the children and parents. Licensee stated she is not currently registered with any Foster Care agency or holds a foster parent license, she was informed if any changes are to occur, Department shall be notified. Based on the Facility Sketch submitted, areas off limits to children and parents are: Licensee has designated the three bedrooms, Office room , One master bathroom, kitchen, laundry room , side walkway and garage as Off-limits areas. (Page-1)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: NAVARRO, PATRICIA	FACILITY NUMBER: 304313952
	VISIT DATE: 11/02/2021

NARRATIVE

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The off- limits are made inaccessible by the Licensee, a child safety gate has been installed at the entrance of the kitchen, as well as a second safety gate has been installed at the end of the kitchen which is the laundry room, all the cabinets in the kitchen have locked stoppers installed making it safe.

The bedroom doors have door knobs installed on the knobs and a stopper on the top making them inaccessible to children. There is also a third safety gate at the end of the passage area. Garage is attached and is accessed through the office room, which is adjoining the bedroom on the left side. Side walk way is inaccessible to children and Licensee has installed a fence making it inaccessible to children.

During the Pre-licensing inspection, LPA observed all the doors were locked with doorknobs installed, with stoppers and child safety gates.

Applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Areas Designated for Day care activities: Licensee has designated living area, dining area, one bathroom, front and back yard for day care activities. The children shall enter through the main door of the home leading into the Day care living room. Licensee has posted the required posters and guidelines are being implemented.

The designated Child Care was observed to have age appropriate toys, educational items. Children shall nap in this area and mats shall be used, linens and blankets shall be provided by the parents but are washed by the Licensee on a weekly basis or as needed. Licensee shall use portable A/C units during summer time and the home has a heating system, heating unit is in a locked cabinet.

Upon entrance through the designated door applicant shall receive the children here, visitors are encouraged to follow CDC guidelines, upon entrance temperatures shall be checked, hands shall be sanitized, and the children shall be guided into the designated day care areas. COVID-19 guidelines and precautions were discussed with the Licensee.

The bathroom is located on the right had side of the passage, children shall walk through the small passage from the living area to gain access to the bathroom, it was observed to be safe and free of hazardous items. There is one cabinet under the sink, it has a child safety lock installed.

Licensee has items needed for infant care including bassinet/ High chair/ changing table, all infant needs shall be provided by the parents. (page-2)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: NAVARRO, PATRICIA	FACILITY NUMBER: 304313952
	VISIT DATE: 11/02/2021

NARRATIVE

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OUTDOOR PLAY AREA: Licensee have designated front yard and back yard area for outdoor activities. Children shall use the front yard for activities, it was observed to be fenced with roller fencing gate on one side which shall be locked during day care activities with the required toys. Licensee shall also use the back yard once the final set up is completed.

Per Licensee there are no firearms, weapons or bodies of water on the premises.

Licensee does have a small dog as a pet, she stated the dog remains in the bedrooms but not in the Day care area. She also stated the pet dog is fully vaccinated.

The value on the 2A10 BC fire extinguisher indicates fully charged, as indicated on service tag observed. Smoke and carbon monoxide detectors were tested and are operable.

There are toys and educational items available for children.

Licensee states that two snacks, breakfast/ lunch and dinner shall be provided, if lunch is to be brought from home, it shall be labelled and stored in their individual bags. Licensee is enrolled in the food program.

Licensee have completed the required Health and Safety with Nutrition and Lead Poisoning component Training and Pediatric First Aid and CPR valid upto 3/20/2023. There are first aid supplies available.

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.

Civil Penalties will be assessed if not in compliance.
*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 Pediatric First Aid and CPR certification and a valid criminal record clearance associated to the facility license.
*Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated. (page-3)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: NAVARRO, PATRICIA	FACILITY NUMBER: 304313952
	VISIT DATE: 11/02/2021

NARRATIVE

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*The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

*Applicant was also made aware of the Child Advocacy program so she could receive the updated Quarterly reports and other information in a timely manner. ChildCareAdvocatesProgram@dss.ca.gov

Reporting Requirements: 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.

Reporting Requirements: 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.
Children and Staff records must be maintained and updated as needed and must be available for review by the Department. No smoking, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

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.

Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.

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.

(Page-4)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: NAVARRO, PATRICIA	FACILITY NUMBER: 304313952
	VISIT DATE: 11/02/2021

NARRATIVE

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Infant Care: Licensee states that she will care for infants. LPA advised the Licensee to sleep infants where they can always be directly supervised and advised against sleeping infants in a separate room. The Licensee states the following as a supervision plan for infants: The infants will sleep where she will be providing supervision and they shall not be left unattended. LPA provided a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. Online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
LPA reviewed with applicant the following safe sleep best practices:
· Always place infants on their backs for sleeping
· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used if they do not have items attached to them
· Infants should not be swaddled or have any items covering them while sleeping
· The temperature of the room should be comfortable enough for an adult to wear a T-shirt and not be too hot or too cold

LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. LPA reviewed and issued the Forms/Records to Keep in Your Family Child Care Home (LIC 311D) and provided the following forms:

Licensee and her son has access to the Guardian program.

Per licensee there are no dual licenses at this address. Licensee's email address was obtained during this inspection and is on file , she was advised that email may be public information.
The facility at the time of Pre-licensing is in compliance for a (Small Family Child Care Home) with Title 22 Regulations, License shall be granted after final approval.

Appeal rights were presented and Exit interview was conducted with the applicants Ms. Navarro, Patricia.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021

LIC809 (FAS) - (06/04)

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