493010771-11-1-2024-01-CC-YYAG-DAM2RU-20241101173806

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 493010771
Report Date: 11/01/2024
Date Signed: 11/01/2024 05:38:12 PM

Document Has Been Signed on 11/01/2024 05:38 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME:	ABREU, PATRICIA FCCH		FACILITY NUMBER:	493010771
ADMINISTRATOR/ DIRECTOR:	ABREU, PATRICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 224-0462
CITY:	PETALUMA	STATE: CA	ZIP CODE:	94954
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	11/01/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Patricia Abreu		TIME VISIT/ INSPECTION COMPLETED:	04:46 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	A change of location inspection was conducted today by Licensing Program Analyst (LPA) Y. Yang. The licensee is requesting a license for a capacity of 14 children. The fire clearance for the approved capacity was received on 10/29/24. Services will be available Mon- Fri 09:00 AM - 04:00 PM. The licensee was previously licensed at facility number 214005518. The licensee understands that 24hr consecutive care is prohibited. The residence is a four bedroom/ two bathroom, dual level home. There are currently two adults living in the home. The licensee was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. The licensee is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance. The floor and yard plans were verified. The licensee provided proof of control of property. The children will have access to the nap room, "play area #1", 'play area #2", downstairs bathroom, and kitchen. The "off limits" areas of the home include the living room,master bedroom, and the entire second floor of the home, which includes three bedrooms and one bathroom. This area has been made inaccessible by a child gate. The home appears to be clean and orderly at this time and will remain so during child care hours. There is a working telephone in the home (licensee's cell phone). The sharp knives, cleaning supplies, medicines, will be stored out of the reach of children. The licensee states there are no firearms and ammunition stored on the premises. Licensee states that poisons are not stored on the premises. The regulation that poisons are to be locked using a key or combination lock was reviewed. First Aid supplies will be maintained at the facility. The children in care have access to age appropriate toys and equipment. The home is equipped with a working smoke detector and a fire extinguisher rated at least 2-A 10:BC. The children have access to part of the fully fenced backyard. The off limits area is fenced off and inaccessible. There is an above ground hot tub with a locked hard cover. There is also a fully enclosed fish pond in an off limits area of the yard. No other bodies of water were observed and none shall be added without prior approval of the Licensing agency. Continued on LIC 809-C

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024

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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: ABREU, PATRICIA FCCH	FACILITY NUMBER: 493010771
	VISIT DATE: 11/01/2024

NARRATIVE

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Incidental Medical Services regulations were reviewed with the applicant. The applicant understands that if Incidental Medical Services are provided, an updated Plan of Operation shall be submitted and on file with the Department. 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. Parents will be required to sign insurance affidavits if the provider does not plan to purchase additional child care liability insurance. Proof of control of property or landlord notification/consent is on file. Parent's rights are posted. Emergency drills must be conducted at least once every six months and the date documented. Children's records to be maintained were reviewed. The children's roster is to remain current at all times.

Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report within seven days. The applicant will maintain current pediatric CPR, First Aid, and child abuse mandated reporter training certifications. The licensee shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. Infants and children shall not be allowed to sleep in car carriers in the home. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage athttps://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. (Continued on LIC809-C)

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024

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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: ABREU, PATRICIA FCCH	FACILITY NUMBER: 493010771
	VISIT DATE: 11/01/2024

NARRATIVE

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Smoking is prohibited at all times in any area where child care is provided. The licensee understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website http://ccld.ca.gov/. The applicant understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice.

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 license-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.

On this date, 10/09/24, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

Exit interview conducted and report was reviewed with the licensee, Patricia Abreu. This change of location application has been approved effective 11/1/24.

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024

LIC809 (FAS) - (06/04)

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