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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418092
Report Date: 12/16/2021
Date Signed: 12/16/2021 04:06:53 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: 0DATE:
12/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Consuelo MacedoTIME COMPLETED:
04:20 PM
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On December 16, 2021 at approximately 12:55pm Licensing Program Analyst (LPA) Russ Haderer met with licensee Consuelo Macedo for the purpose of conducting an unannounced annual inspection for health and safety. The new CARE tool was used for this inspection. Living in the home is the licensee, her TB test and fingerprint cleared husband. Present for today’s inspection was licensee and her fingerprint and TB cleared husband and no children in care. The hours of operation are Monday-Friday, 5:30am to 6:00pm.

The facility is a single-story home with 3 bedrooms and 2 bathrooms, a living room with a screened fireplace, kitchen with an eat-in dining room, attached 2-car garage, front, side and back yards. There is a pool in the backyard with the appropriate 5-foot fence with an outward self-closing gate. There is a locked shed in the backyard, a wooden deck free from defects and dangerous conditions, and grass areas for the children to play.



Toxins, medicines, and hazardous items were inaccessible during today's inspection. Per the licensee, the ISOLATION AREA will be in small hallway going to the bedroom area away from the other children in care.

On-limit-areas include: The kitchen, living room, main house bathroom on the left side of hall, master bedroom (converted into a daycare area) and the master bathroom and backyard area.

Off-limit-areas include: The other two house bedrooms, attached 2-car garage, enclosed pool. All off limit areas are inaccessible by closed and/or locked doors and visual supervision.

There were ample age appropriate toys that were observed to be safe and in good condition. The home and the day care area and rooms are neat and clean, with heating and ventilation for safety and comfort. LPA did not observe any hazardous materials, or toxins accessible to children on the premises during the inspection.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021
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: MACEDO, CONSUELO
FACILITY NUMBER: 013418092
VISIT DATE: 12/16/2021
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There are 2 fully charged 3A40BC fire extinguishers located in the kitchen and master bedroom (converted into daycare room). The facility has working (tested) dual smoke and carbon monoxide detectors. 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 11/24/2021. All required licensing documents are posted and visible for public review.

At 3:00pm, children's files were reviewed and found to be complete. The facility roster was reviewed, and a copy obtained. All files were organized and complete.

The licensee’s Pediatric CPR/First Aid certificate is current and expires 6/2/2023. Mandated reporter training was completed 6/2/2021. As the initial requirement for Licensing, all adults living in the home must be in compliance with immunization laws which pertains to day care providers. Copies were not available at this inspection, however, copies will be forwarded to licensing.

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.



The licensee owns the property but does not carry liability insurance. Parents sign acknowledgement there is no liability insurance.

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

DATE: 12/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021
LIC809 (FAS) - (06/04)
Page: 4 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: MACEDO, CONSUELO
FACILITY NUMBER: 013418092
VISIT DATE: 12/16/2021
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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.

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.

LPA discussed the safe sleep regulations with licensee 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 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.

There were no deficiencies issued during today’s inspection: This report will remain on file for 3 years.

A review of operating safely during the Covid-19 pandemic (RAST) was conducted.



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

Exit interview conducted and report was reviewed with the licensee Consuelo Macedo.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2021
LIC809 (FAS) - (06/04)
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