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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393609167
Report Date: 06/17/2021
Date Signed: 06/17/2021 12:31:13 PM

Document Has Been Signed on 06/17/2021 12:31 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:AVILA, BARBARA JEANFACILITY NUMBER:
393609167
ADMINISTRATOR:AVILA, BARBARA JEANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 814-8945
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/17/2021
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Barbara AvilaTIME COMPLETED:
12:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Christopher Jackson met with licensee Barbara Avila for an unannounced random annual inspection and toured areas of the home accessible to children in care. Off-limit areas include Garage and entire second floor. Licensee acknowledged that children may never enter these off-limit areas. The census included 0 children. Upon arrival licensee stated they were on vacation this week, but allowed LPA to enter the home to complete the inspection. Also present was licensee’s niece. Licensee stated there are no new residents in the home since licensure. All Adult residents have criminal record clearances.

LPA observed current CPR/First Aid certificates which expire on 2/22. LPA discussed licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed two children’s files during today's inspection. LPA observed fire drills were conducted at least once every six months and documented.

LPA observed that there were no hazardous items accessible to children. LPA observed Fireplace was screened. LPA observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Fire extinguisher, smoke detector and carbon monoxide detector meet regulation. Toys appear to be safe. The backyard is fenced and gated. LPA observed an above ground spa on the property. LPA observed it latched and secured on all four sides. LPA discussed checking the locks regularly to ensure safety.


Report Continues on 809-C
SUPERVISORS NAME: Sharon Ogbodo
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/17/2021
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: AVILA, BARBARA JEAN
FACILITY NUMBER: 393609167
VISIT DATE: 06/17/2021
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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 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 and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA discussed licensing requirements, including SB 277 (no longer accepting religious beliefs for immunization's) and SB 792 pertaining to immunization requirements for children and staff - Licensee provided proof of immunization's. During the inspection LPA reviewed COVID19 practices and conducted a technical assistance tour of the facility to incorporate Department of Public Health safety protocols for operating during the pandemic. LPA discussed posting requirements and facility operations including sanitation and pick up/drop off procedures. IN addition LPA discussed the infant sleep regulations. LPA explained 15 minute checks to be conducted on napping infants 24 months and under every 15 minutes and completion of the infant sleep plan to be completed on all infants 12 months and under.

LPA discussed the Mandated Reporter Training with licensee and reminded licensee to renew their training every two years. Volunteers are encouraged but not required to take the training. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English.

LPA checked facilities fees and confirmed that it is up to date.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the licensee and provided copies. An exist interview was conducted. LPA observed the Notice of Site Visit posted and the licensee understands it must remain posted for 30 days.
SUPERVISORS NAME: Sharon Ogbodo
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021
LIC809 (FAS) - (06/04)
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