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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423032
Report Date: 04/18/2023
Date Signed: 04/18/2023 04:32:32 PM


Document Has Been Signed on 04/18/2023 04:32 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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:AVILA, CRISTINAFACILITY NUMBER:
013423032
ADMINISTRATOR:CRISTINA AVILAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 787-2176
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY:14CENSUS: DATE:
04/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:32 PM
MET WITH:Cristina AvilaTIME COMPLETED:
04:15 PM
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RANDOM INSPECTION. Present for this visit was the licensee CRISTINA AVILA, and 3 infants, 8 pre school age children, and 3 fingerprint cleared assistants: Lesly Gomez, and Andrea Figueroa, Ofelia Harojimenez. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:00AM until 5:00 PM, MONDAY-FRIDAY.

The home is single story. The home consists of 9 rooms. The home is neat and clean with heating and ventilation for safety and comfort. The OFF LIMIT AREAS are the master bedroom/bathroom, the first room located on the left in the hallway, the laundry/pantry room, kitchen, the tool shed area, which will be inaccessible by closed and/or locked doors and visual supervision.

The ON LIMIT AREAS are the living/dining room combo, the hallway bathroom, the room located inside the middle of the hallway, and the family room.The ISOLATION AREA will be the bedroom located in the right side of the hallway. Outdoor play area will be inside the backyard which is completely fenced. The outdoor play area is free from defects or dangerous conditions.

There are no pools, hot tubs or any other accessible bodies of water. All hazardous materials and toxins are kept out of the reach of children. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee Health and Safety training is completed and CPR and First Aid certificates are current and expires in Oct, 2023. The licensee is in compliance with new immunization laws which pertain to day care providers. Per applicant, there are no firearms in the home. The licensee's mandated reporter training is current and expires (May, 2023). 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 April 2023. 2 Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sidney CortezTELEPHONE: (510) 295-5031
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2023
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 SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: AVILA, CRISTINA
FACILITY NUMBER: 013423032
VISIT DATE: 04/18/2023
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During Inspection, 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.
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 reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

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.

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

There are no deficiencies cited today.

Exit interview conducted and report was reviewed with the licensee, Cristina Avila.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Sidney CortezTELEPHONE: (510) 295-5031
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023
LIC809 (FAS) - (06/04)
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