Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626458
Report Date: 09/28/2016
Date Signed: 09/28/2016 03:43:48 PM

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:HAMMO, SILVANA FAMILY CHILD CAREFACILITY NUMBER:
376626458
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
09/28/2016
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:28 PM
MET WITH:Silvana HammoTIME COMPLETED:
03:53 PM
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Licensing Program Analyst (LPA), Richard Gumienny made a pre-licensing inspection. Purpose of the visit is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3. Met with Applicant, Silvana Hammo. Applicant was not supervising any day care child during the inspection. Applicant stated that there are no new adults living or working in the home over the age of 18 years. A review of staff records on 9/28/16 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances and T.B. test results prior to working and/or residing in the home. Applicant meets SB792 requirement. Applicant has current CPR & first aid certifications valid through 7/2017. Applicant completed 8 hour Preventative Health training on 9/18/2016. Applicant intends to operate M-F, 6:00am - 10:00pm.

This single level, 3 bedroom, 2 bathroom home was inspected. The entire home will be used for day care including the 3 bedrooms, 2 bathrooms, living room, kitchen, dining room, and fully fenced backyard area. The garage is off limits and made inaccessible to children with door knob cover and lock. There is an operational smoke alarm and fire extinguisher as well as carbon monoxide detector. The home has a properly barricaded fire place in the living room. There are ample space, and napping areas for children. The home has adequate heating and ventilation. Applicant stated that the front yard area will not be used for day care. Applicant reminded that visual supervision is required during all outdoor activities. Applicant stated that there are no weapons on premises. LPA observed no bodies of water on premises. The proper forms are posted. Reviewed all required children files with Applicant.

Discussed Incidental Medical Services with the Applicant. Referred Applicant to ADA website www.ada.gov/childqanda.htm.
SUPERVISOR'S NAME: Debbie HanesTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Richard GumiennyTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2016
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: HAMMO, SILVANA FAMILY CHILD CARE
FACILITY NUMBER: 376626458
VISIT DATE: 09/28/2016
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A license may be issued for the following capacity:

MAX CAP 6 – NO MORE THAN 3 INFANTS OR 4 INFANTS ONLY.
CAP 8 – NO MORE THAN 2 INFANTS, 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

Applicant was advised that upon receipt of a type “A” deficiency, Applicant shall post and provide copies of the licensing report to parents/guardians of children in care at the facility and to parents/ guardians of children newly enrolled at the facility during the next 12 months.

LPA reviewed the following with Applicant: Capacity limitations, supervision, unusual incidents, mandated reporting, Assembly Bill 633, SIDS, Shaken Baby Syndrome, Megan's law. Applicant is reminded that corporal punishment, smoking, baby walkers, exer-saucers, jumpers and bouncy seats shall never be permitted during day-care operation. Also provided prohibited items poster, and capacity poster, disaster drill log.



Applicant was provided appeal rights (LIC9058 12/15) and their signature on this form acknowledges receipt of these rights. Exit interview conducted. www.ccld.ca.gov
SUPERVISOR'S NAME: Debbie HanesTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Richard GumiennyTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2016
LIC809 (FAS) - (06/04)
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