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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629124
Report Date: 06/11/2021
Date Signed: 06/11/2021 02:01:26 PM

Document Has Been Signed on 06/11/2021 02:01 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:PAYANT, VANESSA FAMILY CHILD CAREFACILITY NUMBER:
376629124
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/11/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:33 PM
MET WITH:Vanessa Payant TIME COMPLETED:
02:30 PM
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On 06/11/21 at 12:33 p.m., Licensing Program Analyst (LPA), Rajani Goudreau conducted an announced Pre-Licensing Inspection. Upon visit, LPA met with applicant, Vanessa Payant. LPA conducted a tour of the home and outdoor area to ensure compliance with standards established in CCR, Title 22, Division 12, Chapter 3. This facility is a one story, three-bedroom, two-bathroom house. Facility plans to operate Monday through Saturday from 2:00 a.m. to 12:00 a.m.

All cleaning compounds, detergents, medications and other items which could pose a danger to children are stored where they are inaccessible to children and poisons are to be locked away. The 2A:10BC fire extinguisher, smoke and carbon monoxide detectors are operational, per observation. LPA observed required postings posted. Children’s toys and play equipment are safe and age appropriate. There are no bodies of water observed by LPA during inspection. Children will utilize the backyard for outdoor play. LPA informed applicant to ensure children are supervised at all times during outdoor activities. There are no firearms or other weapons in the home, per applicant. Primary telephone is a cell phone which is operational. Pediatric CPR and First-Aid certificate are valid through April 2023. Applicant states they are financially secure to operate a family childcare home for children and will comply with all regulations and laws governing family childcare homes. A review of clearances on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Applicant rents the facility and has provided proof of control of property by a rental agreement, landlord consent is on file. Applicant has met the immunization requirements, per SB792. Applicant is exempt from the AB1207 Mandated Reporter Training as her first language is Creole. The 8-Hour Preventative Health Training with Lead Poisoning Prevention certificate is on file. The Family Child Care Home Orientation certificate dated April 2021 is on file. LPA informed applicant childcare shall be primarily conducted inside the home. Applicant acknowledges understanding.
See LIC809-C continuation page…
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Rajani Goudreau
LICENSING EVALUATOR SIGNATURE: DATE: 06/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/11/2021
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: PAYANT, VANESSA FAMILY CHILD CARE
FACILITY NUMBER: 376629124
VISIT DATE: 06/11/2021
NARRATIVE
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Licensee will use the following areas for childcare: Living Room, Dining Room, Kitchen, Bathroom located near bedroom #2, bedroom #2 & #3 and backyard. Off limit areas of the home include: Two storage sheds in backyard, east side of backyard, bedroom #1 and bathroom #2. Off limit areas of the home are made securely inaccessible, per observation.

Incidental Medical Services (IMS) policy was discussed. 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 provided 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 and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed California Megan's Law and provided the following to licensee with the following website: www.meganslaw.ca.gov. LPA informed applicant in order to access CCLD-Childcare regulations, licensing forms, pay the annual fee to visit the following website: http://ccld.ca.gov. LPA discussed the following with licensee: to sign up for Quarterly Updates and PINs for one or more programs through our website. Please go to www.cdss.ca.gov and on the right side of your screen click on “Receive Important Updates”, put your email address in and choose which program(s) you would like to subscribe to and click “subscribe.

LPA discussed the following with applicant: reporting suspected child abuse & neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in home have criminal background clearances to avoid civil penalties, emergency drills conducted every 6 months and document drills including date/time and type of drill, heat-related illness, child passenger law, unusual incidents and time frames, Safe Sleep Regulations regarding SIDS, lead poisoning effects brochure. LPA informed applicant corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during day care operation.

LPA discussed with applicant Community Care Licensing Duty Line: (619) 767-2248, open Monday through Friday from 8:00 a.m. to 5:00 p.m. Assigned LPA, Rajani Goudreau may be reached at (619) 767-2215 and at Rajani.Goudreau@dss.ca.gov. See LIC809 Continuation page...
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Rajani Goudreau
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: PAYANT, VANESSA FAMILY CHILD CARE
FACILITY NUMBER: 376629124
VISIT DATE: 06/11/2021
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 LPA discussed the following with applicant: maximum capacity for a small family child care home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the applicants’ home.

An exit interview was conducted with the applicant. The following was discussed and will be provided to the applicant: LIC809 pages and Appeal Rights (LIC9058). After final file review, a small family childcare license will be issued and mailed to the applicant. LPA informed applicant, once the license is received to post in a prominent place in the home.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Rajani Goudreau
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2021
LIC809 (FAS) - (06/04)
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