376626991-5-4-2022-20-CC-LGAO-CE4RAT-20220504125141

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376626991
Report Date: 05/04/2022
Date Signed: 05/04/2022 12:51:53 PM

Document Has Been Signed on 05/04/2022 12:51 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	HEADLEY, NORMA FAMILY CHILD CARE		FACILITY NUMBER:	376626991
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	05/04/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Norma Headley		TIME COMPLETED:	01:00 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	LPA, Luigi Gargaro, conducted an unannounced capacity increase visit with the applicant. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Analyst inquired of the applicant about whether there were any bodies of water or weapons in the home and she replied no. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 03/08/22. First Aid and CPR certifications expire on August of 2022 for the applicant. Applicant will be using the following rooms for childcare: the kitchen, the living room/family room area, the third bedroom (listed as spare room on facility sketch) and the day care bathroom. The following areas will be off limits: the master bedroom (with inclusive master bath), the second bedroom and the garage. The bedrooms are made off limits with door knob covers that are installed on their respective door handles. Though the kitchen cabinets are all latched and inaccessible, applicant optionally puts up plastic gates as barricades to prevent entry into the area when she is cooking or does not want them to have access. The garage is detached from the home and has no entrance from the facility. The applicant has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. The left side alley way stores personal items and is made off limits with a latching gate. 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.

SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: HEADLEY, NORMA FAMILY CHILD CARE	FACILITY NUMBER: 376626991
	VISIT DATE: 05/04/2022

NARRATIVE

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The following information was reviewed with the applicant: information on reporting requirements for suspected child abuse and unusual incidents, children’s records, immunizations, adults living or working in the home and related civil penalties, shaken baby syndrome, and SIDS. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care.

LPA and applicant discussed California Megan's Law and he provided licensee with the website address: www.meganslaw.ca.gov for her to review information regarding her facility on a regular basis. Applicant currently has no infants in care but stated she is aware of the current Safe Sleep regulation requirements. Per her request, however, analyst provided Ms. Headley with a copy of the regulations to have for records.

The home appears to be in sufficient compliance and as no corrections are needed, a license for 14 will be issued effective today. Analyst printed a copy of the Notice Of Site Visit today and had license e place it in her facility notice area before he left the home.

SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

LIC809 (FAS) - (06/04)

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