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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300416
Report Date: 10/05/2021
Date Signed: 10/05/2021 02:40:04 PM

Document Has Been Signed on 10/05/2021 02:40 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:LOPILATO FAMILY CHILD CAREFACILITY NUMBER:
336300416
ADMINISTRATOR:LOPILATO, REBECCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 946-8248
CITY:MENIFEESTATE: CAZIP CODE:
92587
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
10/05/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:13 PM
MET WITH:Lopilato, RebeccaTIME COMPLETED:
02:45 PM
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On date and time listed, Licensing Program Analysts (LPAs) JoAnne Domingo and Nasha King arrived at the facility to conduct a PreLicensing inspection. The applicant was previously licensed and has relocated to a new facility. LPAs conducted COVID-19 Screening question prior to entry. Licensee accompanied LPA on a tour of the facility, inside and out, records were reviewed and the following was observed and/or discussed:
Normal days and hours of operation are: Monday-Friday 8AM-5:30PM
OFF-LIMIT AREAS INCLUDE: Backyard, Garage, 4 bedrooms, 2 baths, Laundry Room, Office, Living Room, Kitchen, Front Entry
· Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the applicant during this inspection.
· All hazardous items inaccessible
· Toxins locked
· No guns or weapons present as of this date. APPLICANT UNDERSTANDS ALL GUNS, WEAPONS AND AMMUNITION MUST BE KEY-LOCKED SEPARATELY AND MADE INACCESSIBLE PER TITLE 22 REGULATIONS.
· Stairs are barricaded
· The fireplace is properly screened
· Verification of control of property on file (viewed grant deed/rental agreement)
· Property owner/landlord notification and consent on file
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights forms are posted
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Nasha King
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2021
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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: LOPILATO FAMILY CHILD CARE
FACILITY NUMBER: 336300416
VISIT DATE: 10/05/2021
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· Pediatric CPR and First Aid Card - expire on 07/2022
· Health & Safety Certificate - completed on 08/01/2020
· There are no bodies of water as of this date. APPLICANT UNDERSTANDS ALL BODIES OF WATER INCLUDING PONDS, ABOVE GROUND POOLS & SPAS, IN-GROUND POOLS & SPAS, AND SOME FOUNTAINS MUST BE PROPERLY COVERED OR FENCED PER TITLE 22 REGULATIONS. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position when not in use.
· Clean, safe and age appropriate toys
· There are no toxic plants observed at this time.
· Current roster on file
· Documentation of fire drills on file
· Children’s records are complete
· Employee’s records are complete
· Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed.
Resident and/or staff records reviewed on (10/05/2021) indicate that all adults who require caregiver background checks have received all required clearances or exemptions.
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov
· Facility is providing IMS This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. A Plan for Providing IMS must be submitted to the Department. The following information regarding 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
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Nasha King
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: LOPILATO FAMILY CHILD CARE
FACILITY NUMBER: 336300416
VISIT DATE: 10/05/2021
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and the ADA, available at: http://www.ada.gov/childqanda.htm.
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

The following was reviewed with the applicant(s):
- Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
- AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For a Zero Tolerance violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Zero Tolerance violation the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected.
NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
- AB 1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning January 1, 2018 – In accordance with California Health and Safety Code Section 1596.8662 – requires all licensed providers, applicants, directors and employees to complete
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Nasha King
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: LOPILATO FAMILY CHILD CARE
FACILITY NUMBER: 336300416
VISIT DATE: 10/05/2021
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training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. This training is free of cost and available at: www.mandatedreporterca.com/ and are provided in English and Spanish. If no training is made available in a required person’s primary language then those persons shall be exempt from this requirement
- AB2370 – Effective January 1, 2019 – Lead Poisoning – providers are required to provide a lead toxicity prevention handout to parents/guardians of newly enrolled and newly reenrolled children with information on risks and effects of lead poisoning; blood lead testing recommendations and requirements; and options for obtaining blood lead testing, including free and/or discounted testing. There will be a training component of this added to the Preventative Health Training beginning July 1, 2020.

- Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility’s phone numbers must be on file at all times.
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The applicant is urged visit the U.S. Consumer Product Safety Commission webpage at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled
- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Nasha King
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: LOPILATO FAMILY CHILD CARE
FACILITY NUMBER: 336300416
VISIT DATE: 10/05/2021
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v Access to Forms, Title 22 Regulations and Provider Information Notices (PINS) for a Child Care Center are online at www.ccld.ca.gov.

v Please subscribe at www.childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov

v The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov

v The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

Once all corrections have been made, with proof sent to licensing, the application for a Small Family Child Care Home will be submitted for approval with a maximum capacity of 6, or 8 with parent notification. As agreed upon by the applicant, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application may be withdrawn.

During the exit interview, the APPLICANT, Rebecca Lopilato confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

As a REMINDER: when your child(ren) turn 18 years of age, you MUST SUBMIT an updated LIC279, LIC508 and TB Screen, MMR (measles), TDAP (pertussis), and FLU (influenza shot or a written, signed and dated declination) and have your child submit for LIVESCAN background clearance. This also applies to any adult PRIOR to them moving
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Nasha King
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: LOPILATO FAMILY CHILD CARE
FACILITY NUMBER: 336300416
VISIT DATE: 10/05/2021
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into the home or who currently lives in the home. Also, PRIOR to employment of any adult, you must submit their LIC508, and obtain a background clearance through LIVESCAN; TB screening MMR (measles), TDAP (pertussis), and FLU (influenza shot or a written, signed and dated declination); a copy of their current EMSA CPR & First Aid Cards; and a copy of their Mandated Child Abuse Reporter Certificate.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Nasha King
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021
LIC809 (FAS) - (06/04)
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