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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005553
Report Date: 06/24/2021
Date Signed: 06/24/2021 06:19:23 PM

Document Has Been Signed on 06/24/2021 06:19 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:KUHNHAUSEN, KATIA L.FACILITY NUMBER:
214005553
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/24/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Katia Kuhnhausen TIME COMPLETED:
04:10 PM
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On 6/24/21 at 03:00 pm., Licensing Program Analyst (LPA), Farhan Bashir-Tariq conducted a scheduled PreLicesing inspection for a small family child care home and met with Applicant, Katia Kuhnhausen. This inspection was conducted via Face Time due to COVID-19 restrictions. Purpose of inspection was explained. LPA verified the background check clearance of adults working or living in the home. Applicant rents the home, which is a three bedroom and two-bathroom house. Hours of operation will be: M-F, 7:30 am- 5:30 pm. Applicant will not provide any meals at this point. Children will bring their own food for now. Applicant was instructed to have some emergency snack supplies available for children in care. Daycare areas: Living room /Play area, Back yard (only deck area) and Bathroom #2. OFF limit areas: Bathroom #1, Bedroom #1, Bedroom #2, Bedroom #3, Kitchen, 3 Closets located in hallway and Back yard area beyond the deck point.

LPA and Applicant virtually inspected the entire home for health and safety hazards. All off limit areas were properly barricaded and made inaccessible to children in care. License and other required licensing documents will be posted outside by the back door. Living/Play room will be used as main child care area. Children will use the living room for playing, napping or changing. All electric outlets in living room were secured with child safety covers. Fire place in living room was secured with a safety lock thus making it inaccessible from children. LPA observed that there were toys, books, arts and furniture available in the living room to be used by children in care. All three bedrooms are off limit and will not be used for children. Entrance towards the bedrooms has been blocked off with a baby gate. Bathroom # 2 located in hallway will be used for children. Kitchen is off limit. A baby gate was installed at kitchen entrance and all kitchen cabinets were also secured with safety locks. Chemicals were stored in kitchen cabinet under sink. All sharp and harmful objects were stored and made inaccessible from children in care. Home was observed to be clean and orderly with enough lighting and ventilation. Deck area in back yard was approved to be used for child care. Deck area is fully fenced all around and have a baby gate at the end. Per Applicant, back yard beyond the deck area point will not be used for child care.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2021
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: KUHNHAUSEN, KATIA L.
FACILITY NUMBER: 214005553
VISIT DATE: 06/24/2021
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There was a smoke detector, a carbon monoxide detector, a fully charged fire extinguisher of size 2A10BC or bigger and a working telephone available in the home. Applicant tested both detectors for this inspection. First Aid Kit was available and fully stocked. Applicant stated that are no firearms or weapons present in home. Per Applicant, there are no bodies of water/ swimming pools in the home. Per Applicant, there are no pets in the home. Applicant was reminded to conduct and log a fire and emergency drill at least once every six months. Applicant has a current and valid First Aid and CPR card expiring in May 2023. Mandatory child abuse training certificate was submitted to LPA. Applicant completed her training on 6/22/21. This training is valid for two years. Applicant was reminded of NO walkers, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible. Applicant was reminded about the Provider Information Notices (PINs) on the CCLD website. During the inspection, LPA provided information and assistance about issues related to COVID-19. Applicant was reminded to clean and disinfect childcare areas thoroughly at least once a day. Posters containing information for COVID-19 symptoms, face coverings and hand washing were observed to be posted in home and child care areas. Hand washing posters was observed to be posted in children’s bathroom.

LPA reminded Applicant that all adults, 18 years and older living in the home, helper, or assistant must have finger print clearance and must be associated to the facility by submitting an LIC 9182 with a copy of CDL or CA. ID prior to having any contact with children in care failure to do so could result in an immediate civil penalty. LPA reminded Applicant that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPA reminded Applicant , as of January 1, 2018, all staff is required to complete Mandated Child Abuse Reporter Training (AB1207) every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encouraged Applicant to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Applicant can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: KUHNHAUSEN, KATIA L.
FACILITY NUMBER: 214005553
VISIT DATE: 06/24/2021
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This report was discussed and explained to Applicant. Records to be maintained in the facility were discussed and a copy of Form 311D was emailed to Applicant. Mandatory Posting Requirements: License, Emergency Disaster Plan, and Notification of Parent's Rights Poster. Capacity limits of a small family child care license has been discussed. A handout explaining capacity and ratio limits was emailed to Applicant along with this report.
Small Family Child Care Home license is approved and will be effective as of today, 06/24/21.

This report will be kept in the facility file and will be made available for public review upon request. Desk duty is available M-F, 8AM-5PM at (650) 266-8800. Website for forms and Regulations: www.cdss.ca.gov.


















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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021
LIC809 (FAS) - (06/04)
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