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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418092
Report Date: 07/15/2019
Date Signed: 07/15/2019 12:50:18 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:MACEDO, CONSUELOFACILITY NUMBER:
013418092
ADMINISTRATOR:MACEDO, CONSUELOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 790-8231
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:14CENSUS: 6DATE:
07/15/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Consuelo MacedoTIME COMPLETED:
01:05 PM
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Licensing Program Analyst (LPA) Julia Placencia arrived at 11:15am for an unannounced Annual/Random Inspection, and met with Licensee Consuelo Macedo. Present for this inspection were four infants, two preschool age children, and the licensee's fingerprint cleared spouse. Also residing in the home are the licensee's two fingerprint cleared daughters. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Saturday, 6:30am to 6:00pm.

ON LIMITS: Kitchen, dining room, living room, bedroom on left in hallway, hallway bathroom, backyard.

OFF LIMITS: Remaining two bedrooms, garage. Off limit areas are inaccessible by closed and/or locked doors and visual supervision. .

The home is single story, which is neat and clean, with heating and ventilation for safety and comfort. The outdoor play area is fenced, has a wooden deck, and is free from defects and dangerous conditions. There is also a swimming pool that is properly fenced/gated. 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. Fire extinguisher, carbon monoxide and smoke detector meet State Fire Marshall standards. The fireplace is screened and has glass doors. 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 7/3/19. All required licensing documents are posted and visible for public review.

At 12:00pm, 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 licensee and helper's Pediatric CPR/First Aid certificate is current and expires 5/2020. Licensee has proof of the required immunizations and current mandated reporter training. 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. ***Continued on LIC809C...
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2019
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: MACEDO, CONSUELO
FACILITY NUMBER: 013418092
VISIT DATE: 07/15/2019
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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.

There were no deficiencies cited during today's inspection. This report shall remain on file for 3 years. A Notice of Site visit was posted at time of inspection and must remain posted for 30 days.

Exit interview conducted with Consuelo Macedo. Copy of report and appeal rights provided.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Julia PlacenciaTELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2019
LIC809 (FAS) - (06/04)
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