Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001992
Report Date: 11/19/2019
Date Signed: 11/19/2019 05:02:20 PM

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:LABBE, CHRISTINEFACILITY NUMBER:
384001992
ADMINISTRATOR:LABBE, CHRISTINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 648-1824
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:14CENSUS: 9DATE:
11/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Licensee, Christine LabbeTIME COMPLETED:
05:25 PM
NARRATIVE
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Licensing Program Analyst (LPA), Luis J. Gomez made an unannounced annual inspection. LPA met with Licensee, Christine Labbe. Present in the facility is licensee and helper caring for 9 children (3 Infants 6 Preschool age). Licensee's daughter arrived during today's inspection. Licensee is within capacity limits of the large license on this day. Licensee’s home is a 1- bedroom, 1- bathroom House. Hours of Operation are: Mon- Fri: 8:00am- 6:00pm. Daycare areas: Living room (Play room), Bathroom #1 Off Limit areas are: Kitchen, Bedroom #1, Hallway and Entire lower level.

At 3:35pm on November 19, 2019 LPA inspected the home for health and safety hazards with the licensee. Daycare area has a variety of age appropriate wooden toys, games and blocks for the children. Home is clean, with proper temperature and ventilation. Per licensee, there are no guns or weapons in the home. Bathroom #1 is kept clean, in good repair, and maintained with adequate supplies. Licensee installed child safety locks on all cabinets in the bathroom #1. Licensee stated she prepares all daily snacks and meals.
All cleaning supplies, poisons and other chemicals are stored inaccessible to children. There are several child size tables and chairs. Home has a working telephone, a smoke detector, carbon monoxide detector, and a fully charged fire extinguisher located in the entry way.

Six children's and two personnel files were reviewed. The children files were complete and had all required emergency identification information. Facility roster was reviewed and is complete. Emergency drills are done at the facility with the last drill conducted on, 11/2/2019, and properly logged. Licensee’s CPR/ 1st aid certification is current expiring: 11/2021. At 3:50pm on November 19, 2019, Based on a file review, LPA observed facility helper without proper fingerprint clearances on file.

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SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
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: LABBE, CHRISTINE
FACILITY NUMBER: 384001992
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
11/20/2019
Section Cited

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102370(d)(1) Criminal Record Clearance. All individuals subject to criminal record review as specified in section 1596.871 prior to working residing or volunteering in a licensed home. shall obtain a California clearance or criminal record exemption as required by the department. This requirement is not met as evidenced by.
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Based on observations and a file review, LPA Gomez confirmed that facility helper does not have the proper criminal record clearances on file. This is an immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 11/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/19/2019
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: LABBE, CHRISTINE
FACILITY NUMBER: 384001992
VISIT DATE: 11/19/2019
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Incidental Medical Services (IMS) was discussed. Licensee has no children who need services at this time. 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. The following information regarding Americans with Disabilities Act (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: www.ada.gov/childqanda.htm.

During inspection,
· Licensee was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.662.
· Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com
· Licensee was reminded about the Provider Information Notices (PINs) on CCLD website.
Licensee was advised for any additional questions to contact CCLD office, Monday to Friday, 8:00 am - 5:00 pm, (650) 266-8800 or 1 (844) 538-8766. Website: www.cdss.ca.gov

· Licensee was provided "Effects of Lead Exposure" information



Based on today's inspection, deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Ca. Code of Regulations. A plan of correction was developed with the licensee and exit interview was conducted with, Christine Labbe and her signature of this form acknowledges receipt of these documents.

>This report and rights to comment and appeal were discussed with Site Supervisor. This report must be available in the facility for public review. Notice of site inspection was posted.
Site Supervisor was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
LIC809 (FAS) - (06/04)
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