Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819620
Report Date: 04/19/2017
Date Signed 04/19/2017 07:59:18 AM

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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:MACIEL FAMILY CHILD CAREFACILITY NUMBER:
334819620
ADMINISTRATOR:MACIEL, MARINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 343-5924
CITY:THOUSAND PALMSSTATE: CAZIP CODE:
92276
CAPACITY:14CENSUS: 1DATE:
04/19/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
07:15 AM
MET WITH:Marina MacielTIME COMPLETED:
08:05 AM
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On date and time listed, Licensing Program Analyst (LPA) Dale Green arrived to the facility to conduct an annual visit. LPA toured the facility inside and out and records were reviewed. The following was observed and/or discussed:
Normal days and hours of operation are: M-F 7am-5pm
OFF-LIMIT AREAS INCLUDE: All bedrooms, Garage & Backyard.

The facility is operating within the licensed capacity and appropriate ratios
The licensee is present in the home and has ensured that children in care are supervised at this time
When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children
There is a working telephone is present
There is an appropriate fire extinguisher, smoke detector and carbon monoxide detector present. Both detectors were tested by the applicant during this visit
All hazardous items are inaccessible, to include: detergents, cleaning compounds, medications and other items which could pose a danger to children
Storage of poisons is inaccessible to children and locked
The fireplace is properly barricaded
There are no guns or weapons present as stated by the licensee
There are no stairs at the home
Home is clean and orderly. There is adequate heating and ventilation for safety and comfort
There are safe and appropriate toys and equipment present for both indoor and outdoor activities.
Outdoor play areas are fenced or appropriate supervision is present
Verification of control of property on file
Property owner/landlord notification and consent on file
Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted
Pediatric CPR and First Aid Card expire on 11/2018

Continued on 809C
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dale GreenTELEPHONE: (951) 782-7464
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2017
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: MACIEL FAMILY CHILD CARE
FACILITY NUMBER: 334819620
VISIT DATE: 04/19/2017
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Health & Safety Certificate - completed on 10/2007
There are no bodies of water at this time. 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.
There are clean, safe and age appropriate toys
Documentation of fire drills is on file
Each child’s file contains a copy of the emergency information card with required information
The licensee states no associations to any other facilities
Criminal record clearances were checked on 4/18/17
The Department was granted inspection authority as required by the Health and Safety Code

Facility is not currently providing IMS 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

The following was reviewed with the licensee(s):

AB 2084 - Nutritious Beverages in Child Care Facilities effective January 1, 2012
AB 1918 – Smoking prohibition on the premises of Family Child Care Homes, effective January 1, 2015
AB 2621 – Public information posted on the internet, effective January 1, 2015
AB 2386 – Carbon Monoxide Detector Regulations, effective January 1, 2015
AB 2236 – Civil Penalties, effective July 1, 2015
SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016
AB290 – Child Nutrition, effective January 1, 2016
SB792 – Immunization requirements for staff, volunteers, effective September 1, 2016

Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov
Please subscribe to My CCL on our website. Department updates will be sent directly to your e-mail account once you have set up an account.

Continued on 809C
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dale GreenTELEPHONE: (951) 782-7464
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2017
LIC809 (FAS) - (06/04)
Page: 2 of 3


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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: MACIEL FAMILY CHILD CARE
FACILITY NUMBER: 334819620
VISIT DATE: 04/19/2017
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It is the responsibility of the individual to know the regulations for anyone providing care
Inaccessibility of hazards must be constantly reassessed
The 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 is to be conducted every six months
Understand the responsibilities of being a mandated reporter
Baby walkers, bouncy seats, exersaucers and other similar items are prohibited

The applicant is urged to 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.

Criminal record clearances 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.

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.

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

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

A notice of site visit was issued and is to be posted in a prominent location at the facility for the next 30 days along with a copy of all type A deficiencies (lic9099d) cited during this visit. A copy of all type A deficiencies cited during this visit must also be immediately (within 24 hours of the child’s next day in care) given to the parents of all children enrolled in the child care facility and any children enrolled into the child care facility over the next 12 months (at the time of enrollment).

A Confidential Names List was completed and provided to the licensee.

A copy of this report was provided to the applicant on this date and must be made available to the public upon request for the next 3 years.
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dale GreenTELEPHONE: (951) 782-7464
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2017
LIC809 (FAS) - (06/04)
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