<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417512
Report Date: 03/21/2023
Date Signed: 03/21/2023 12:43:13 PM


Document Has Been Signed on 03/21/2023 12:43 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:GARCIA, MARIA TERESITAFACILITY NUMBER:
013417512
ADMINISTRATOR:GARCIA, MARIA TERESITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 309-1166
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY:14CENSUS: 10DATE:
03/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Maria Teresita Garcia- LicenseeTIME COMPLETED:
12:55 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 03/21/23, Licensing Program Analyst (LPA) Plumboy arrived to the facility to conduct an Unannounced 1 YEAR inspection. LPA was met by Licensee Maria Teresita Garcia. Present during today's visit was the Licensee fingerprint cleared spouse Tomas Garcia, and 10 day care children (2 infants and 8 preschoolers). This facility currently operates from 7:00am until 6:00pm. The licensee accompanied LPA Plumboy on a tour of the home and backyard.

The home is two stories. There is a barricade/gate at the bottom of the stairs which was in place during today's inspection. The ON LIMIT AREAS are the entire first level of the home except the laundry room and garage. The OFF LIMIT AREAS are the laundry room, garage, and entire second level of the home which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be the living room. The BACKYARD play area is completely fenced. There are toys, activities, and equipment.

There are no pools, hot tubs or any other bodies of water present during today's inspection. There are no play structures present at the facility during today's inspection which are required to be anchored. There are no pools, hot tubs or any other bodies of water present during today's inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home.

Licensee Maria Teresita and Tomas Garcia's CPR and First Aid certificates are current and expire 5/2/23. Tomas Garcia and Maria Teresita have mandated reporter training certificates which were received 04/2022. The licensee and her husband Tomas are in compliance with the immunization law. The facility conducts and documents fire and disaster drills twice a year with the last one conducted on 3/20/23.
At 12:04pm, 2 Children files were reviewed. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2023
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 2


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: GARCIA, MARIA TERESITA
FACILITY NUMBER: 013417512
VISIT DATE: 03/21/2023
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
26
27
28
29
30
31
32
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
Per licensees assistant, there are no children in care at this time requiring IMS

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 Teresita Garcia 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 Teresita Garcia 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 Teresita Garcia.

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

DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2