Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393610678
Report Date: 03/23/2016
Date Signed: 03/23/2016 10:32:48 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:TOVAR GARCIA, MARIAFACILITY NUMBER:
393610678
ADMINISTRATOR:MARIA CARMEN TOVARFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 952-5728
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:14CENSUS: 7DATE:
03/23/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Maria Tovar GarciaTIME COMPLETED:
10:45 AM
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3. Licensing Program Analyst (LPA) Dominick Conde met with licensee Maria Tovar Garcia for an annual/random visit and toured areas of the home accessible to the children. Off-limit areas include the garage, laundry room and upstairs. Licensee acknowledged that children may never enter these off-limit areas. The census included one infant, two school aged children and four preschool children. Licensee stated there are no new residents in the home, and all adult residents have criminal record clearances. The facility's hours of operation are Monday through Friday from 5:30am - 5:30pm.

LPA observed current CPR/First Aid certificates (expired 3/29/2016), posted License, Parents' Rights Poster and Emergency Disaster Plan. LPA reviewed children's records and client roster. LPA discussed new 2015 and 2016 laws that passed including smoking on the property, immunization changes and carbon monoxide detector.

LPA observed hazardous items properly stored out of children's reach. The licensee stated that the gas fireplace has been turned off by PGE. Licensee stated there are no weapons in the home. Fire extinguisher, carbon monoxide detector and smoke detector meet regulation. LPA observed fire drills documented on a fire drill log. The backyard is fenced and there were no bodies of water on the property. LPA provided the Licensing Agency website (www.ccld.ca.gov), so the licensee may obtain updated licensing information, regulations, and forms.

This facility is not providing Incidental Medical Services-IMS at this time. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family child care home evaluator manual (FCCH EM) Policy 102417.

The facility is in substantial compliance today, no deficiencies were cited.

Exit interview conducted. Notice of Site Visit was provided.
SUPERVISOR'S NAME: Monica R FiliceTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Dominick CondeTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2016
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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