013421273-10-16-2024-02-CC-ACUY-DA56KP-20241016205305

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421273
Report Date: 10/16/2024
Date Signed: 10/16/2024 08:53:10 PM

Document Has Been Signed on 10/16/2024 08:53 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	MENDEZ, SARA MARINA		FACILITY NUMBER:	013421273
ADMINISTRATOR:	MENDEZ, SARA MARINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 499-1932
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94702
CAPACITY:	14	CENSUS: 8	DATE:	10/16/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Sara Marina Mendez		TIME COMPLETED:	11:15 AM

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 10/16/2024 at 9:30 AM Licensing Program Analyst (LPA), A. Curry arrived at the home and conducted an unannounced annual/required inspection. LPA met with licensee, Sara Marina Mendez, who granted inspection authority to tour the facility. Also present for the inspection were licensee’s fingerprint cleared spouse and 8 children in care, consisting of 1 infant and 7 preschoolers. Licensee states there are currently 8 children enrolled. Children’s files were reviewed. The home has 3 levels. The on-limit areas are the front yard, upstairs bathroom, and living room. The children also walk through the kitchen to access the downstairs play room and backyard as well. The off-limits areas are the 2 upstairs bedrooms and garage, which will be inaccessible by closed and/or locked doors and visual supervision. The isolation area is in the living room. The LPA toured all areas used by children. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. The fireplace has been made inaccessible to children. There are safe toys, play equipment, and materials observed for children. There is a safety gate at the bottom of the stairs on the middle level of the home to prevent access to the upper part of the home. There is a door to prevent access to the lower level of the home and another safety gate at the bottom of the stairs of the lower level to prevent access to the upper levels. All poisons, cleaning solutions, medications, and other items that pose a danger to children are inaccessible during this visit. The licensee does understand that poison must be in a locked cabinet/drawer or placed out of reach of children. The home is equipped with a fully charged 2A10BC fire extinguisher and working dual smoke alarm/carbon monoxide detector. Licensee states there are no firearms on the premises. There are no pools, spas, hot tubs, fishponds or similar bodies of water. Licensee has current CPR and First Aid training which expires on March 28, 2026. AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com. Licensee completed the training on January 08, 2023.

SUPERVISOR'S NAME: Monica Mathur	TELEPHONE: (510) 365-5196
LICENSING EVALUATOR NAME: Ashley Curry	TELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: MENDEZ, SARA MARINA	FACILITY NUMBER: 013421273
	VISIT DATE: 10/16/2024

NARRATIVE

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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. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months of age should be placed on their back for sleeping. The licensee was reminded that all infants up to 12 months of age shall have the LIC 9227 form placed in their file.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview the licensee, Sara Marina Mendez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted, appeal rights were given, and report was reviewed with the licensee, Sara Marina Mendez.

SUPERVISOR'S NAME: Monica Mathur	TELEPHONE: (510) 365-5196
LICENSING EVALUATOR NAME: Ashley Curry	TELEPHONE: 510-566-1562
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC809 (FAS) - (06/04)

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