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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423365
Report Date: 02/21/2020
Date Signed: 02/21/2020 10:47:46 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ALVARADO, ZULEYKA & HUAMANI, MILTONFACILITY NUMBER:
013423365
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
02/21/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Zuleyka Alvarado and Milton HuamaniTIME COMPLETED:
10:55 AM
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LPA L. Dyer met with licensees Zuleyka Alvarado and Milton Huamani for an unannounced Case Management - Licensee Initiated/Increase In Capacity inspection. The licensees were present with one fingerprint cleared assistant and 6 preschool children.

LPA toured the facility for a health and safety inspection. Licensees have requested that the family room be added as an on-limit area. This request was granted. The home was equipped with a first aid kit, a fully charged 2-A:10-B:C fire extinguisher, a working smoke detector (tested), and a carbon monoxide detector. Fire safety inspection by the Oakland Fire Department was approved on 2/03/20 with Code 1 - Fire Clearance Granted. Fire marshal verified that licensees have: a fire drill log, smoke detectors in day-care rooms, no unsecured items that pose a hazard, and other requirements.

Licensees had files for all children in care. She declined to review forms. No stairs inside the home. There was a working telephone. Licensees stated there were no firearms, pets or bodies of water on the premises. There were a variety of books and toys for children's use. Children play in the fenced back yard. Area has faux grass and a variety of toys such as balls, play kitchen, riding toys, slides, swings, etc.

The last disaster drill logged was 10/18/19. Licensees stated they were the only adults living in the home. All staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensees fees are current. Pediatric First aid and CPR cards expire on 6/2/20 and 10/5/21. Licensee's immunization records have been reviewed. Mandated Reporter Training expires on 5/29/20 and 6/3/20. All licensing-required documents are posted. The ratio poster was discussed and given to the licensees. The handout, "A Child Care Provider's Guide to Safe Sleep" was provided and discussed at the last inspection and discussed again today.
(continued)
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis DyerTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020
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 2
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ALVARADO, ZULEYKA & HUAMANI, MILTON
FACILITY NUMBER: 013423365
VISIT DATE: 02/21/2020
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Individual 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.

Licensees were reminded that anyone working, residing or frequently visiting the home must be fingerprint cleared prior to being in the presence of children, or an immediate civil penalty can be assessed; and to notify the department IN WRITING if she decides to move or discontinue the license. Zero Tolerance Regulations were also discussed.

A QUALIFIED ASSISTANT MUST BE PHYSICALLY PRESENT AND INVOLVED IN CARING FOR CHILDREN WHENEVER 9 OR MORE CHILDREN ARE PRESENT AT A LARGE FCCH. WHEN AN ASSISTANT IS NOT PRESENT, THE HOME REVERTS BACK TO SMALL FAMILY CHILD CARE RATIOS.

License for Increase In Capacity is recommended pending receipt of all final clearances and the completion of all requirements.

A license will be processed as soon as administratively possible.

For CCL Updates, go to www.ccld.ca.gov. Click the "Receive Important Updates" box. Enter your e-mail address.

Exit interview conducted. This report must be kept available for public review for 3 years. Notice of site visit must be posted for 30 days.
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis DyerTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2