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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313626249
Report Date: 11/08/2024
Date Signed: 11/08/2024 11:06:27 AM

Document Has Been Signed on 11/08/2024 11:06 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:RILEY SILVA, MICHELLEFACILITY NUMBER:
313626249
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/08/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Michelle Riley SilvaTIME VISIT/
INSPECTION COMPLETED:
11:10 AM
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On November 8, 2024, Licensing Program Analyst (LPA) Lea Habtom met with applicant for a scheduled Pre- Licensing inspection, this is a change of location. Applicant was previously licensed under facility # 313624241. Applicant owns the home, control of property was provided. LPA and applicant toured the entire home inside and out. LPA explained about obtaining $300,000 liability insurance. Applicant understands that until a policy is obtained, she must use the affidavit form LIC282. Applicant’s hours of operation are planned to be from Monday-Friday from 7:30 am to 5:00 pm and other hours as arranged. Applicant agrees to notify licensing if her days of operation will change or another job is obtained.

Applicant is registered for the CPR course on November 30, 2024. She agrees to send proof of completion of the course within 90 days of completion.

Applicant has certificate of completion for 7 hours of health and safety training and is pending to take the CPR and First Aid.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Applicant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Off-limit areas include: bedroom 1, laundry room, bedroom 2, master bedroom, master bathroom and garage. Applicant understands that children may never enter these off-limit areas. Applicant understands that she needs to notify licensing for any modification inside and out of the home. There is a weapon in the home.

LPA reviewed the requirement of maintaining a fire drill log and a children’s roster. There is no fireplace in the home. Fire extinguisher, carbon monoxide detector and smoke detectors meet regulation. Hazardous cleaning compounds are inaccessible to children.


Report Continued on LIC809C
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: RILEY SILVA, MICHELLE
FACILITY NUMBER: 313626249
VISIT DATE: 11/08/2024
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Sharp utensils and medications are inaccessible to children. Applicant understands that 100% supervision is required in any unfenced areas. There is no body of water. The backyard is fenced.

LPA Habtom discussed SB277 (public health vaccination) and SB792 (day care facilities: Immunization exemptions) with Applicant at time of inspection. Applicant has met the requirements of SB792 and her vaccination record is in the RO file.

LPA observed that applicant has completed the required mandated reporter training (AB1207) at website: www.mandatedreporterca.com.

LPA discussed and gave applicant the Effects of Lead Exposure brochure. LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep web page 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.

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)/ (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 provided the Community Care Licensing website www.ccld.ca.gov, so the Applicant can obtain updated licensing information, new regulations and access forms. LPA advised Applicant of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

Report continued on the following page LIC809C
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: RILEY SILVA, MICHELLE
FACILITY NUMBER: 313626249
VISIT DATE: 11/08/2024
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Licensee stated she does not need licensing forms and is familiar with licensing forms.

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 platform.

To receive important licensed- related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Provisional license is pending approval for weapons and ammunition storage in the home. Licensee will follow up with LPA L. Habtom.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
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