503911539-9-30-2021-04-CC-NLOI-C7CQRV-20210930122434

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503911539
Report Date: 09/30/2021
Date Signed: 09/30/2021 12:24:45 PM

Document Has Been Signed on 09/30/2021 12:24 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	GARCIA, SABRINA FAMILY CHILD CARE		FACILITY NUMBER:	503911539
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/30/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Sabrina Garcia		TIME COMPLETED:	12:45 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	Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On September 30, 2021, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Sabrina Garcia for a pre-licensing inspection. Applicant, her husband and two minor children reside in the home. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: This is a single story, three bedrooms and two bathrooms home and children will have access to the living room, kitchen/dining room, bedroom #1 (play room), bedroom #2 and hallway bathroom. Off-limits rooms are made inaccessible by key locks. There is a fireplace in the living room that applicant states it will not be used during day-care hours. LPA observed in bedroom #1; children size furniture, safe toys and books for the children. There is a diaper changing table and an infant swing in bedroom #2. LPA also observed a high chair in the dining room and a flat screen television mounted onto the wall in the living room. Children will nap in the living room or bedroom #1 on mats. Infants will nap in a crib. Applicant states that she will only be providing care and supervision to her own infant. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. (Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GARCIA, SABRINA FAMILY CHILD CARE	FACILITY NUMBER: 503911539
	VISIT DATE: 09/30/2021

NARRATIVE

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Applicant’s Pediatric CPR and First Aid certification was completed through America Red Cross and expires on July 17, 2023.
Preventative Health and Safety with Prevention of Lead exposure certification was completed on July 22, 2021.
Knives are stored on top of the refrigerator. Medications are stored inside a top kitchen cabinet. Cleaning compounds are stored inside a hallway closet that is made inaccessible by the use of a privacy door kob lock.
Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
There are no bodies of water in the home or premises.
There is a cat that is kept indoors and will be accessible to the day care children. There is a gallon fish tank in bedroom #2. There are two dogs that are kept gated on a gates area in the backyard of the home. The dogs will not be accessible to the day care children. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
Firearms are stored in accordance with Title 22 Regulations and ammunition is stored separate in accordance with Title 22 Regulations.
Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
Applicant states she will be transporting day care children. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GARCIA, SABRINA FAMILY CHILD CARE	FACILITY NUMBER: 503911539
	VISIT DATE: 09/30/2021

NARRATIVE

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Fenced backyard has a cemented and sodded are for the day-care children. There is a Little Tikes peddle and go cart, toddler slide and toddler basketball hoop. There is a secured baby swing with safety straps mounted onto the patio porch. The patio porch will be used for shade. LPA also observed a wooden slide play structure. There is a gated side run of the home where potential hazardous items are stored and will be inaccessible to the day care children.
SB 792 immunizations verified and on file.
Applicant completed the Mandated Reporter Training on July 9, 2021.
LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. She is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday from 7:00 AM to 4:00 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

Licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended effective October 4, 2021.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021

LIC809 (FAS) - (06/04)

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