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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500698
Report Date: 11/04/2022
Date Signed: 11/04/2022 04:25:46 PM

Document Has Been Signed on 11/04/2022 04:25 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:LOVE, LEONELAFACILITY NUMBER:
394500698
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
11/04/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Leonela Love TIME COMPLETED:
04:40 PM
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On November 4, 2022, 2022, Licensing Program Analysts (LPAs) Stacey Williams and David Nguyen met with Applicant, Leonela Love for the purpose of a pre-licensing inspection. Present during the inspection was Applicant’s husband and minor child. Criminal record clearances were verified.

LPAs and Applicant toured single-story home. The home sit on approximately 2.3 acres and consists of 6 bedrooms,2.5 bathrooms, livingroom, kitchen and dining area, pantry room, animal coupes (chicken, rooster, peacock), goat area, rabbit area, cage- free geese, horse area, RV carport, whale house and 3- car garage. Off limit areas: (outside: RV carport, whale house, rooster pen, and left side field area where horses are located and the garage. Inside: four bedrooms, 1 bathroom, pantry room, exercise weight room).

A copy of the control of property is on file. Applicant provided a copy of the Deed of Trust. Applicant has completed the required Preventative Health and Safety course which includes 1 hour of nutrition and lead prevention training. LPA provided blank forms required for staff records as well as for children's records including LIC 9227- Individual Infant Sleeping Plan. Applicant has a designated Licensing Area where required forms such as Parent's Rights Notification, Emergency Disaster Plan, Earthquake Preparedness Checklist and the Facility Sketch is posted. This area is where Licensing forms/posters will be placed for parental review.

LPAs and Applicant toured the outside facility. The front yard is fenced aside from the driveway entrance. There is no gate in the front yard. The backyard is also fenced. There are no standing bodies of water on the property; however, there is an additional fenced area were Applicant stated an above ground pool will be placed in the future.

** Continued on subsequent page, LIC 809C **

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2022
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: LOVE, LEONELA
FACILITY NUMBER: 394500698
VISIT DATE: 11/04/2022
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Applicant stated there are weapons in the home. LPAs observed the ammunition and firearms are stored in a separate safe in an off-limit area. Applicant understands the smoking prohibition for childcare.

LPAs observed the kitchen cabinets are properly secured. All medications and knives are stored and inaccessible.

LPAs observed a 2A10BC fire extinguisher. LPAs observed an operational smoke detector and carbon monoxide detector in the home that meet regulatory standards. Applicant understands that if any structural changes are made to the home; licensing must be notified prior to construction.


LPAs and Applicant discussed Safe Sleep Regulations and Covid-19 Guidance for Childcare Providers.

LPAs 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.


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, 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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information , see PIN 22-02-CCP. 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


** Continued on subsequent page LIC 809 C **
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2022
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: LOVE, LEONELA
FACILITY NUMBER: 394500698
VISIT DATE: 11/04/2022
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Applicant has completed the required AB1207 Mandated Reporter training. Applicant understands that the training must be completed once every two years, training is accessible at www.mandatedreporterca.com. CPR/First Aid certification is current and expires 6/2023.

Applicant understands that a current roster must be maintained and that fire drills must be conducted and documented once every six months. Applicant understands that licenses are not transferable, and once licensed, licensee must live in the home and be present for 80% of the operating hours. LPA explained to applicant that if she relocates and wants to continue to provide care, she must submit a change of location application and have the new home inspected.

Applicant understands that if an unusual incident occurs; licensing is to be notified via phone call, e-mail or fax within 24 hours and the Unusual Incident Report LIC 624 shall be submitted within seven days to remain in compliance.

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.

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.

Applicant will remain in pending status until further approval from management regarding the front and backyard space.

Exit interview conducted with Applicant.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2022
LIC809 (FAS) - (06/04)
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