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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010214011
Report Date: 12/30/2019
Date Signed: 12/30/2019 03:54:46 PM

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:ESTACIO, ANGELITAFACILITY NUMBER:
010214011
ADMINISTRATOR:ESTACIO, ANGELITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 443-6549
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY:14CENSUS: 5DATE:
12/30/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:01 PM
MET WITH:Angelita & Manny EstacioTIME COMPLETED:
04:10 PM
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Licensing Program Analyst (LPA’s) Leslie Ibo & Manel Estoesta arrived at facility of Angelita Estacio for an unannounced Annual/Random Inspection, and met with licensee and licensees husband Manny Estacio. Present for this inspection were 2 infants and 3 preschool aged children. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday 7:30 AM – 5:30 PM.

ON LIMITS: kitchen, nap room, garage converted into day care room, and fenced back yard, hallway bathroom
OFF LIMITS: are all the bedrooms/master bathroom, and half of the right side of the back yard
ISOLATION: nap room inside the day care area

The home is one story, which is neat and clean, with heating and ventilation for safety and comfort. The outdoor play area is fenced, and is free from defects and dangerous conditions. There were ample age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. There is a fully charged fire extinguisher, working carbon monoxide and smoke detectors, telephone, and first aid kit. Per licensee, there are no firearms in the home. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 11/5/2019. All required licensing documents are posted and visible for public review.

SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Leslie IboTELEPHONE: (510) 622-2646
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2019
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: ESTACIO, ANGELITA
FACILITY NUMBER: 010214011
VISIT DATE: 12/30/2019
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At 3:20 pm children's files were reviewed and found to be complete. the facility roster was reviewed, and a copy obtained. The licensee is in ratio today. The licensees' Pediatric CPR/First Aid certificate is current and expires 10/26/2021, the husband’s CPR/First Aid Certificate expires 10/26/2021.

Licensee has proof of the required immunizations, and mandated reporter training is current expiration date 3/13/20. Safe Sleep practices were discussed, and new car seat laws were provided. Licensee was reminded that children are never to be left in a parked vehicle.



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.
Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, 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 encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. Safe sleep practices were discussed with licensee, and information was provided.
There were NO deficiencies observed during today's inspection.
A Notice of Site visit was posted at time of inspection and must remain posted for 30 days. Exit interview conducted with Angelita Estacio. Copy of report and appeal rights provided.
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Leslie IboTELEPHONE: (510) 622-2646
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2019
LIC809 (FAS) - (06/04)
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