013422725-7-19-2021-52-CC-BPLY-C53Q9C-20210719115807

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422725
Report Date: 07/19/2021
Date Signed: 07/19/2021 11:58:13 AM

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:	PRIETO ARANGOITIA, ARACELLY		FACILITY NUMBER:	013422725
ADMINISTRATOR:	ARACELLY PRIETO-ARANGOITIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 400-9900
CITY:	UNION CITY	STATE: CA	ZIP CODE:	94587
CAPACITY:	14	CENSUS: 0	DATE:	07/19/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Aracelly Prieto Arangoitia- Licensee		TIME COMPLETED:	12:00 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 7/19/21, Licensing Program Analyst Briana Plumboy met with licensee Aracelly Prieto Arangoitia for an UNANNOUNCED REQUIRED 1 YEAR RANDOM INSPECTION. The home was toured to conduct a Health and Safety Inspection. The family child care home currently operates Monday through Friday from 7:30am until 5:30pm. The facility has been closed due to the COVID-19 pandemic, but the licensee plans to reopen her facility in August 2021. The home is two stories. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS are the family room, downstairs bathroom, and backyard. The OFF LIMIT AREAS are the garage, formal dining room, living room, kitchen, laundry room, and entire second level of the home which will be inaccessible by closed and/or locked doors and visual supervision. The family room has been designed as a classroom. There is a gate at the bottom of the stairs to prevent access to the stairs and second level of the home. The ISOLATION AREA will be an area inside the family room. The BACKYARD play area is fenced, and contains a play structure which is anchored to the ground and has cushioning material underneath to absorb a fall. There are child safety gates throughout the home located at the entrance to the kitchen from the family room, at the base of the stairs, and from the entrance of the home to the living room. 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 the inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. The licensees CPR and First Aid certificate is current and expires 04/17/23. The licensee and her husband are in compliance with the immunization law. The licensee obtained a certificate of completion in mandated reporter training on 06/24/21 The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home. All REQUIRED forms are posted and visible for public review. See 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021

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: PRIETO ARANGOITIA, ARACELLY	FACILITY NUMBER: 013422725
	VISIT DATE: 07/19/2021

NARRATIVE

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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

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 624B). 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

There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. This entire report was read to licensee by LPA Plumboy. Appeal rights provided and discussed. Exit interview conducted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021

LIC809 (FAS) - (06/04)

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