394500450-9-14-2021-53-CC-CJAN-C6USYG-20210914141731

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500450
Report Date: 09/14/2021
Date Signed: 09/14/2021 02:17:39 PM

Document Has Been Signed on 09/14/2021 02:17 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:	DURAO, RACHEL & DURAO, SAMANTHA		FACILITY NUMBER:	394500450
ADMINISTRATOR:	DURAO, RACHEL & DURAO, SAM		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 665-5947
CITY:	MANTECA	STATE: CA	ZIP CODE:	95336
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 1	DATE:	09/14/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Rachel & Samantha Durao		TIME COMPLETED:	02:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Christopher Jackson met with applicants Rachel and Samantha Durao to conduct a pre-licensing inspection for a large family home day-care. All adult individuals subject to criminal background review have obtained a criminal record clearance and are cleared through the department. LPA and applicants toured all areas of the single-story home. The home consists of a living room, bathroom, kitchen, one master bedroom, two smaller bedrooms, garage and a fenced in backyard area. The backyard has a trampoline. LPA discussed following the manufactures guidelines when in use with children in care. During today's inspection applicant noted the following Off limit areas: bedroom #1, bedroom #2, master bedroom, backyard and garage. Off-limits areas will remain inaccessible to children by closed doors and/or supervision. During the inspection LPA observed the fireplace in the living room is appropriately barricaded to prevent access by children. LPA observed toxic and hazardous items are inaccessible to children. Functioning smoke and carbon monoxide detectors and a 2A10BC fire extinguisher were observed in the home. LPA discussed the $300,000 liability insurance with the applicant during today’s inspection. LPA observed the pediatric CPR and first aid for applicant Samantha Durao which expires on 05/22/2023. Applicant Rachel Durao has enrolled in a Pediatric First Aid and CPR course. Applicant will provide proof of completion to LPA upon completion of the course. Applicant has completed the Preventative Health and Safety course which includes 1 hour of nutrition and the newly added lead component training. Applicant stated there are no weapons in the home. There were no bodies of water were observed on the property during today's inspection. Report continues on 809-C

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

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: DURAO, RACHEL & DURAO, SAMANTHA	FACILITY NUMBER: 394500450
	VISIT DATE: 09/14/2021

NARRATIVE

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LPA provided copies and discussed forms required for children's records with applicants. LPA provided copies of the current immunization card and information on proposed Safe Sleep Regulation Concepts. LPA provided documents for seat belt/booster seat laws, vaccination requirements for staff and children. LPA discussed smoking prohibitions.

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.
(report continued on next page, LIC809C)

LPA discussed with the applicant any poisons, such as bug spray poisons or plant poisons in the home must be locked with a key lock or combination lock. LPA discussed the AB1207 Mandated Reporter training and the requirement to conduct the training every two years upon initial completion. The Mandated Reporter training is accessible at www.mandatedreporterca.com. Applicant understands that a current children's roster must be maintained and retained for children going back three years. LPA discussed that a fire drill must be conducted and documented at least once every six months.

LPA discussed the infant sleep regulations with applicants. LPA explained infants 12 months and under must have the LIC 9227, infant sleep plan on file. In addition LPA explained that 15 minute checks must be done on all infants 24 months and under during their nap time. LPA provided applicants with a copy of LIC 9227. 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.

Report Continues 809-C

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: DURAO, RACHEL & DURAO, SAMANTHA	FACILITY NUMBER: 394500450
	VISIT DATE: 09/14/2021

NARRATIVE

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Applicant understands that anyone living or working in the home, eighteen years of age or older must obtain fingerprint clearance prior to living or working in the home. Applicant understands that licenses are not transferable, and once licensed, licensee must live in the home and be present for 80% of the operating hours. Applicant understands that if an unusual incident occurs; licensing is to be notified via phone call, e-mail or fax within 24 hours and the Unusual Incident Report LIC 624 shall be submitted within 7 days to remain in compliance. Applicant understands that if any structural changes are made to the home; licensing must be notified prior to construction. Applicant understands that if they want to make any off-limit area an ON-limits area, they must notify licensing and LPA must do an inspection before children are allowed in the area. Applicant understands that children’s records are to be maintained according to Title 22 regulations, and be accessible to licensing for up to three years.

A copy of this facility evaluation report was review with the applicant. Records, postings and reporting requirements were discussed. LIC311D was provided and discussed. Applicant was encouraged to visit the department website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to family child care homes.

The following to be submitted prior to licensure:
1) Pictures showing front fountain filled in to stop any water from pooling and brought to compliance according to Title 22 Regulations

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Christopher Jackson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

LIC809 (FAS) - (06/04)

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