013412437-6-24-2019-02-CC-LDYN-BDFV8D-20190624161236

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013412437
Report Date: 06/24/2019
Date Signed: 06/24/2019 04:12:40 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	MANZANERO, HILDA & RENAN		FACILITY NUMBER:	013412437
ADMINISTRATOR:	MANZANERO, HILDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 536-8736
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	14	CENSUS: 8	DATE:	06/24/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Hilda Manzanero		TIME COMPLETED:	04:25 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	On 6/24/19 at 2:30pm, Licensing Program Analyst (LPA) Loretta Dyson arrived at the home for an unannounced random inspection. Both of the licensees were present. The licensee's fingerprint cleared assistant A. Alvarez and 8 preschool age children were also present. At 2:42pm, LPA requested and reviewed the files of 4 children in care. LPA spoke with H. Manzanero about using the PM 286 form to document children's immunizations. The facility roster was reviewed, and a copy was obtained. The licensees have current CPR/first aid certificates, and H. Manzanero's expire on 10/20/20 and R. Manzanero's expire on 10/2/19. The licensee's assistant, A. Alvarez, also has certificates that expire on 11/3/20. The licensees conduct and document fire and earthquake drills at least once every 6 months, and the log indicates that the last earthquake drill was conducted on 2/5/19 and the last fire drill was conducted on 5/15/19. At 3:25pm LPA toured of the areas of the home that are used for the child care, to conduct a health and safety inspection. The home has 3 levels and is neat and clean with heating and ventilation for the safety and comfort of children in care. The on limit areas include the living room which is only used for napping, the kitchen where children eat, office, child care room, the bathroom inside of the child care room and the hallway bathroom on the first floor. All other areas of the home, including the entire second floor and basement, are off limits and made inaccessible by gate, closed and/or locked doors and visual supervision. The isolation area will be the office, away from other children in care. The fully fenced backyard is used for outdoor play, and it is free from defects or dangerous conditions. LPA observed wood chips, which are sufficient to absorb a fall, underneath the play structures. LPA observed an ample supply of toys and activities, which are age appropriate and in good condition. LPA did not observe any bodies of water, hazardous items or toxins accessible today. Per the licensee, there are no firearms in the home. LPA observed that all required forms are posted and visible for public review. The fireplace in the living room is blocked to prevent access by children. There is a gate at the bottom of the stairs leading up to the second floor. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, fully stocked first aid kit and telephone.

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2019

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: MANZANERO, HILDA & RENAN	FACILITY NUMBER: 013412437
	VISIT DATE: 06/24/2019

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This facility plans to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. A Plan for Providing IMS has been submitted to Licensing for review. 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. LPA reviewed the individuals associated to the license, and the licensee confirmed that everyone who is required to have a criminal record clearance is associated. Licensee was reminded of the responsibility as a mandated reporter. The licensee was advised of the required mandated reporter training to be completed as of 1/1/18, at www.mandatedreporterca.com.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to sign up to receive quarterly updates by email by sending a request to ChildCareAdvocatesProgram@dss.ca.gov. The Licensee was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet and LPA discussed safe sleep practices and policy.

There are no deficiencies being cited today. This report shall remain on file for 3 years. A Notice of Site visit was given to Licensee, and Licensee was reminded that it is required to be posted for 30 days. An exit interview was conducted with H. Manzanero.

SUPERVISOR'S NAME: Anika Evans	TELEPHONE: (510) 286-4350
LICENSING EVALUATOR NAME: Loretta Dyson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2019

LIC809 (FAS) - (06/04)

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