414004914-9-15-2022-05-CC-CQUO-CJAPYM-20220915114409

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004914
Report Date: 09/15/2022
Date Signed: 09/15/2022 11:45:03 AM

Document Has Been Signed on 09/15/2022 11:45 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	VIRUELL, VIOLET		FACILITY NUMBER:	414004914
ADMINISTRATOR:	VIRUELL, VIOLET		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 232-9652
CITY:	FOSTER CITY	STATE: CA	ZIP CODE:	94404
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/15/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Violet Viruell		TIME COMPLETED:	12:00 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	On September 15, 2022 at approximately 8:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an announced, pre-licensing inspection. LPA met with applicant, Violet Viruell, and explained the purpose of the inspection. No other individuals were present in the home during LPA's visit. Home received fire clearance 07/25/2022. Applicant provided evidence of at least 1 year experience working in a licensed family child care home. Applicant rents the home with their spouse and 2 minor children. Applicant is to provide department proof of control of property. Applicant is aware minor children under 10 years old, living in the home, are to be counted towards facility's overall capacity. With applicant, LPA inspected the home for health and safety hazards. Applicant plans to operate from Monday to Friday from 8:30am to 5:30pm. Applicant plans to care for children from 12 months to 6 years old. The home is a single level, single family home that consists of 3 bedrooms, 2 bathrooms, 2 living rooms, play room, kitchen, dining area, backyard and 2 side alleys. The DAY CARE AREAS are the playroom, living room #1 that is converted to a classroom (located next to playroom), bathroom #1, and backyard. The OFF-LIMIT AREAS are all 3 bedrooms, bathroom #2 (located in master bedroom), kitchen, dining area (pass by only), living room #2 (pass by only), and side alleys. Off limit areas are properly barricaded with child safety gates and/or child safety locked door knobs. Access to the backyard is through dining area and living room #2 which are to be pass by only. LPA observed the home to be clean and safe. Home is equipped with multiple smoke and carbon monoxide detectors, multiple fully stocked first aid kits and a fully charged fire extinguisher. All electrical outlets children will have access to are made inaccessible with child safety covers. LPA observed poisons, chemicals and other hazardous materials to be stored inaccessible in home's high shelves and/or locked behind child safety locked cabinets. Harmful and sharp objects are stored inaccessible from children in off limit areas. (Continue on Page 2...)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

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

FACILITY NAME: VIRUELL, VIOLET	FACILITY NUMBER: 414004914
	VISIT DATE: 09/15/2022

NARRATIVE

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Applicant uses a designated cell phone and is aware the cell phone must stay within the home during the day care hours. LPA observed backyard to be fully enclosed with an at least 5 ft. high fence. Backyard includes age appropriate toys and materials that were observed to be new, in good working condition. LPA observed backyard to have a play structure that has resilient padding (turf) underneath.

Applicant was reminded baby walkers, bouncers, and jumpers are not to be used for children in care. Applicant plans to provide sleeping cots and/or cribs for enrolled children in care. Safe sleep regulations, laundering, COVID-19 guidelines and sanitization were discussed. LPA reminded applicant emergency disaster drills are to be conducted and documented once every six months.

Per applicant, there are no firearms or pets in the home. Applicant's discipline policy will be redirection. The designated isolation area will be in the classroom or playroom, separate from other children in care. Applicant plans to provide a food service with breakfast, snack and lunch. Food storage, labels, sanitization and children's allergies were discussed. Applicant is aware children who bring their own food to the home are to label their own personal belongings.

The applicant's CPR is current and will expire 11/2023. Applicant has proof of immunizations (MMR, Tdap, Tb and Flu) that was provided to the department. The applicant completed Mandated Reporter training on 09/07/2022. LPA informed applicant Mandated Reporter training must be completed by every staff member hired and must be renewed every 2 years.

This facility plans to provide Incidental Medical Services –IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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
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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: VIRUELL, VIOLET	FACILITY NUMBER: 414004914
	VISIT DATE: 09/15/2022

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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.

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.

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.

Prior to recommended licensure, following must be completed:
-Posting of Notification of Parents Rights (PUB394).
-Submission of proof of control property.
-Submission of photo I.D.s for all adults living in the home.

Exit interview conducted and report was reviewed with the applicant, Violet Viruell.

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

LIC809 (FAS) - (06/04)

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