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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013415205
Report Date: 02/11/2022
Date Signed: 02/11/2022 03:30:14 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:SORIA ALCAZAR, MARIAFACILITY NUMBER:
013415205
ADMINISTRATOR:SORIA ALCAZAR, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 606-0397
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:14CENSUS: 3DATE:
02/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Maria Soria AlcazarTIME COMPLETED:
03:40 PM
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On February 11, 2022 at approximately 11:40am Licensing Program Analyst (LPA) Russ Haderer met with licensee Maria Soria Alcazar for the purpose of conducting an unannounced 1-year annual inspection for Health and Safety compliance. Present for today’s inspection was the licensee, her fingerprint cleared daughter and three infant children in care. During the inspection 4 more children arrived (1 infant, 1 toddler, one school age child). The facility is in ratio today. The hours of operation will be Monday-Friday, 7:00 AM to 6:00 PM.

The facility is a 5-bedroom, three bath 2-story home an attached 2-car garage, enclosed (fenced) backyard play area. There is a fireplace in the family room with a screen. The home is neat and clean with heating and ventilation for safety and comfort. Per the licensee, the ISOLATION AREA will be in the living room away from the other children in care.



On-limit include: Downstairs child care room, child care eating area (west side of kitchen), hallway, bedroom for napping on middle left side of hall, back bedroom for napping on back left side hall, house bathroom at the end of the hall and the backyard. Licensee was reminded that other than wipes or things used for the children in the children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area.

Off-limits include: Kitchen, living room, back bedrooms on the right side of the hall, upstairs (stairs clicked by a shut and locked door), and attached 2-car garage. Off limit areas are inaccessible by closed and/or locked doors, child gates and visual supervision.
Licensee has ample age-appropriate toys and learning materials in the home. There is a fully charged 3A40BC fire extinguisher in the child care room; a working smoke and carbon monoxide detector (tested and functioning), and a working telephone.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 5
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: SORIA ALCAZAR, MARIA
FACILITY NUMBER: 013415205
VISIT DATE: 02/11/2022
NARRATIVE
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Disaster drills are conducted every month, the last one was done 2-3-2022. Per licensee, there are no firearms in the home. LPA did not observe any bodies of water, hazardous materials, or toxins accessible to children on the premises during the inspection. The back yard play area has age appropriate toys and small structures. Licensee has two first aid kits in the kitchen.

The Licensee’s and her daughter’s CPR and First Aid certificate are current and expires (licensee 1/16/2023; daughter 4-10-2023). The licensee mandated reporter training (verified AB1207) is current, expires on 11/24/2022. The licensee’s daughter did not have proof of TB test available; licensee and daughter are in compliance with all other immunization laws which pertains to day care providers. See LIC809D.



LPA reminded the licensee of the following: Mandated Reporter training is to be renewed every two years; CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.

At 12:45pm, LPA reviewed children’s and facility files. Licensee does not carry liability insurance, all children’s files contained signed acknowledgement forms from parents.

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 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.


SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: SORIA ALCAZAR, MARIA
FACILITY NUMBER: 013415205
VISIT DATE: 02/11/2022
NARRATIVE
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LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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.


To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

There was one Type B deficiency issued during today’s inspection, see LIC809D.

A review of Covid safety precautions was completed.

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

Exit interview conducted and report was reviewed with the licensee Maria Soria.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: SORIA ALCAZAR, MARIA
FACILITY NUMBER: 013415205
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as there was no proof of TB test available for adult daughter providing assistance with child care which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/25/2022
Plan of Correction
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Licensee will provide proof of TB test to LPA.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 02/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5