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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013421856
Report Date: 09/11/2019
Date Signed: 09/11/2019 03:10:02 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:DUGARTE, SONIAFACILITY NUMBER:
013421856
ADMINISTRATOR:DUGARTE, SONIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 742-5508
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY:14CENSUS: 16DATE:
09/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:08 AM
MET WITH:Sonia DugarteTIME COMPLETED:
03:30 PM
NARRATIVE
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On 09/11/19, Licensing Program Analyst Briana Plumboy met with licensee Sonia Dugarte for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was fingerprint clear and associated assistant A.Lopez, 3 unfingerprinted assistants/adults (F.Morfin, E.Valqui, and C.Ramirez), 3 infants, and 13 preschoolers. The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday through Thursday from 7:00am until 6:00pm, and Fridays from 7:00am until 5:30pm.

On 09/11/19, LPA arrived to the home at 10:08am. LPA Plumboy rang the doorbell and there was no answer. LPA Plumboy rang the doorbell 3 times and then looked through the kitchen window which was opened and had a screen and said "Hello Licensing." Assistant F.Morfin walked by and looked at LPA Plumboy and continued past the window. At 10:16am, licensee S.Dugarte arrived at the facility and welcomed LPA into the home. The home is a single story house consisting of 3 bedrooms, 2 bathrooms, living room, dining room, kitchen, play room, office and attached garage. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the living room, family room, second bedroom on the right side of the hallway, the hallway bathroom, and the dining room. The OFF LIMIT AREAS are master bedroom and bathroom and the last bedroom at the end of hallway, the office, and the garage which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be the second bedroom on the right side of the hallway. The BACKYARD play area is fenced. The yard and outdoor area other than the patio is off limits to children in care. There are toys and learning materials. There are no pools, hot tubs or any other bodies of water present in the on limit areas during today's inspection.

The home has a fully charged 2A10BC fire extinguisher, smoke detector, carbon monoxide detector, and working telephone. The licensee CPR and First Aid See 809-C and 809-Ds for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019
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 8
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: DUGARTE, SONIA
FACILITY NUMBER: 013421856
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/12/2019
Section Cited

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Criminal Record Clearance. All individuals subject to a criminal record review as specified in Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption as required by the Department.
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This requirement is not met as evidenced by:
S1, S2, and S3 were helping at the facility today and interacting with the children. S1, S2, and S3 do not have a criminal record clearance, which poses an immediate health and safety risk to children in care.
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FCCH.
**Immediate civil penalty of $1,500 is assessed today.Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type A
09/12/2019
Section Cited

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102416.5(a) Staffing Ratio and Capacity. The capacity specified on the license shall be the maximum number of children for whom care can be provided.
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This requirement is not met as evidenced by:
Based on observation, a physical census, and interview, the facility is over capacity today with 3 infants and 13 preschool age children in care which poses an immediate health and safety risk to children in care.
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LPA to revisit to ensure Licensee is remaining within Capacity. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 09/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/11/2019
LIC809 (FAS) - (06/04)
Page: 3 of 8
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: DUGARTE, SONIA
FACILITY NUMBER: 013421856
VISIT DATE: 09/11/2019
NARRATIVE
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The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility. Licensee was reminded of Departments inspection authority, with our without any notice.

Effective August 1, 2003 California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care.

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 reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list



A Non Compliance Conference is being held on Thursday, September 19, 2019 at 1:00pm the Oakland Regional Office located at 1515 Clay Street Suite 1102 Oakland, CA.

The attached Type A deficiencies are cited today. Upon receipt, licensee shall post for 30 days and provide copies of this licensing report to parent/guardians of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 Acknowledgement of Receipt of Licensing Reports should be signed by guardians and placed in each child’s file.

See (5)809-Ds for citations cited today. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Appeal rights provided and discussed. Exit interview conducted.

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

DATE: 09/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019
LIC809 (FAS) - (06/04)
Page: 5 of 8
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: DUGARTE, SONIA
FACILITY NUMBER: 013421856
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/11/2019
Section Cited

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Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. THIS IS BASED ON RECORD REQUEST BY LPA PLUMBOY WITH LICENSEE.
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ASSISTANTS S1, S2, AND S3 DO NOT HAVE PROOF OF HER PROVIDER IMMUNIZATIONS WHICH POSES A POTENTIAL RISK TO CHILDREN IN CARE.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type B
09/16/2019
Section Cited

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Personnel Records
(a) Personnel records shall be maintained on each employee...
This requirement was not met as evidenced by:
Based on observation:
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the facility does not have files on their staff which poses a potential health and safety risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 09/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/11/2019
LIC809 (FAS) - (06/04)
Page: 7 of 8
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: DUGARTE, SONIA
FACILITY NUMBER: 013421856
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/12/2019
Section Cited

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Fire Safety Clearance.Fire Safety Clearance. A fire safety clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal shall be required for a large family child care home.
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Based on observation, the licensee is operating outside the terms of her fire clearance. There are 16 children present whom are not of school age or enrolled in school today which poses an immediate health and safety risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type A
09/12/2019
Section Cited

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Enforcement Provisions. Any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice.
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This requirement was not met based on evidence: there were 4 adults insdie the facility, and LPA Plumboy rang the doorbell 3 times and then looked through the kitchen window which was opened and had a screen and said "Hello Licensing." By not allowing licensing into the home until the licensee arrived poses an immediate health and safety risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 09/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/11/2019
LIC809 (FAS) - (06/04)
Page: 4 of 8
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: DUGARTE, SONIA
FACILITY NUMBER: 013421856
VISIT DATE: 09/11/2019
NARRATIVE
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certificate is current and expires 01/2020. The licensee's mandated reporter training is complete and she received a certification of completion on 03/31/18. The licensee and Ana are in compliance with the immunization law. The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 06/20/19.

The licensee is NOT in ratio today, over capacity, and has violated her fire clearance due to there being 16 children present today. All REQUIRED forms are posted and visible for public review.

During today's annual random inspection, the licensee is being cited the following:
1) There was 4 adults in the home prior to the licensee's arrival, and none of the adults could provide proof of CPR/First aid certificates during the inspection
2) For 3 uncleared/ unfingerprinted and not associated adults being present and caring for children during today's inspection
3) Conduct Inimical due to licensee not being honest with LPA Plumboy
4) The facility is over capacity today with 3 infants and 13 preschool age children in care
5) Fire Clearance- there are 16 children present during today's inspection
6) Inspection Authority- the assistants did not let LPA Plumboy into the home. LPA Plumboy was let into the home when the licensee arrived
7) The licensee does not have staff files for record review for her assistants
8) There are no immunization records on file for the assistants/adults present today
9) The roster not being completed
10) Children's record

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

LPA Plumboy provided a copy of Safe Sleep in Child Care brochure, a handout "What Does A Safe Sleep Environment Look Like?," and PIN 19-06-CCP to the licensee
See 809-C and 809-Ds for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2019
LIC809 (FAS) - (06/04)
Page: 2 of 8
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: DUGARTE, SONIA
FACILITY NUMBER: 013421856
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2019
Section Cited

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Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement was not met as evidenced by:
Based on interview and record review, the licensee does not
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 have a completed roster for all children in care. LPA Plumboy review the roster and found it to be incomplete. By not having a complete roster, this poses a potential health and safety risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type B
09/16/2019
Section Cited

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102421 Child's Records
This requirement was not met as evidenced by:
Based on record review of the 16 files for the 16 children in care, they are missing forms
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which poses a potential health and safety risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 09/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/11/2019
LIC809 (FAS) - (06/04)
Page: 8 of 8
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: DUGARTE, SONIA
FACILITY NUMBER: 013421856
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2019
Section Cited

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Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the
facility or the people of this state.
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This is based on interview with the licenseee when she told LPA Plumboy one of the assistants was watching a child who was not in the licensees care or part of the FCCH which poses a potential health and safety risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type B
09/27/2019
Section Cited

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Personnel Requirements. The Licensee and other personnel as specified shall complete training on preventive health practices including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
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This requirement was not met as evidenced by: the assistants were present without the licensee upon LPAs arrival and the assistants do not have CPR/First aid certificates available. When the licensee arrived, there was an adult provider present with valid CPR/First Aid. certificate poses a potential health and safety risk to children care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 09/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/11/2019
LIC809 (FAS) - (06/04)
Page: 6 of 8