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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010208968
Report Date: 06/30/2022
Date Signed: 06/30/2022 03:23:12 PM


Document Has Been Signed on 06/30/2022 03:23 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:BENTANCUR, MARIAFACILITY NUMBER:
010208968
ADMINISTRATOR:ZERBINI, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 489-0625
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:12CENSUS: 9DATE:
06/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Maria Bentancur- LicenseeTIME COMPLETED:
03:34 PM
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On 6/30/22 at 1:45pm, Licensing Program Analyst Briana Plumboy met with licensee Maria Bentancur for an UNANNOUNCED REQUIRED 1 YEAR RANDOM INSPECTION. Present for this visit was licensees fingerprint clear husband Luis Bentancur, 3 infants, and 5 preschool age, and 1 school age child. The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday through Friday from 6:00am until 6:00pm.

The home is single story. The home has heating. The ON LIMIT AREAS are the hallway bathroom, the kitchen/dining room, the last two rooms on the left side of the hallway, the patio/play room, and the middle portion of the backyard. The left and right sides of the backyard is fenced off and off Limits to the children. The ISOLATION AREA will be the second room located on the left side of the hallway. There are toys that appear to be safe. The licensee has current daycare insurance for this facility. There are no pools, hot tubs or any other bodies of water present in the on limit areas during today's inspection. There is a bird bath located in front of the home in the front yard. Per licensee, children in care do not play in the front yard. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible to children during today's inspection.

The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The licensee and her husband Luis' CPR and First Aid certificates are current and licensee's CPR/First Aid expires on 09/09/23 and Luis' expires on 09/28/23. The licensee has a report she's had her water tested for lead. The licensee and and her husband Luis Bentancur's mandated reporter training's are complete and they received a certification of completion on 6/3/22. The licensee and her husband Luis are in compliance with the immunization law. The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts fire and disaster drills at least twice a year with the last one conducted on 5/9/22. The licensee documents infant sleep checks during nap time and utilizes Lic. 9227.

(5) Children files were reviewed and facility roster reviewed. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. See 809-C for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/30/2022
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: BENTANCUR, MARIA
FACILITY NUMBER: 010208968
VISIT DATE: 06/30/2022
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Incidental Medical Services (IMS) policy was discussed. 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

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensee Maria Bentancur and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Maria Bentancur of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days.

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Maria Bentancur.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022
LIC809 (FAS) - (06/04)
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