013423559-12-14-2021-02-CC-ASIH-C9PVXD-20211214154923

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423559
Report Date: 12/14/2021
Date Signed: 12/14/2021 03:50:17 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	RIVAS VALDEZ, MARCOS		FACILITY NUMBER:	013423559
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	12/14/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Marcos Rivas Valdez		TIME COMPLETED:	04:00 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 12/14/2021 at 02:00 PM Licensing Program Analyst (LPA) Arminder Singh met with Licensee, Marcos Rivas Valdez and Husband for an announced Capacity Increase inspection. There are no children present today. During inspection there was the Licensee and Husband present. Days and hours of operation are Mon - Friday, 6 AM to 6:00 PM. The home is a single story home, which is neat and clean with heating and ventilation for safety and comfort. The home consists of dining room, living room, kitchen, two bedrooms, two bathrooms, day care room, and an outdoor play area The OFF LIMIT AREAS are the living room, dining room, both bedrooms, the bathroom which are located in the front part of the home. The off limits areas will be inaccessible by closed and/or locked doors, child proof gates and visual supervision. The ON LIMIT AREAS are the day care room which is located in the rear of the home. Bathroom number two which is located near the day care room is also on limits. The backyard is also on limits. The ISOLATION AREA will be a corner of the day care room which is closer to the bathroom. The applicant understands that full supervision needs to be provided while children are in care. The applicant will be taking children to the local park. There are ample age appropriate toys that are safe and appear to be clean and in good repair. There are no pools, hot tubs or any other bodies of water. LPA did not observe any hazardous materials or toxins accessible to children today. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, carbon monoxide detector, telephone, and fully stocked First Aid Kit. The applicant’s Health and Safety training is completed and CPR and First Aid certificate is current.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: RIVAS VALDEZ, MARCOS	FACILITY NUMBER: 013423559
	VISIT DATE: 12/14/2021

NARRATIVE

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Outdoor Yard: The outdoor play area is free from defects or dangerous conditions and is fully fenced. There are ample age appropriate toys that appear to be safe and in good condition. There are no pools, hot tubs or any other bodies or hazardous materials and toxins which are kept out of the reach of children. The outdoor play area is fully fenced and secure. Licensee understand that 100% supervision is required at all times.

This facility is not providing Incidental Medical Services - IMS at this time. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family child care home evaluator manual.

REMINDERS/RESOURCES

· Criminal Background Clearance: All assistants, volunteers, frequent adult visitors (adults are individuals 18 years of age or older) must be fingerprint cleared and associated to the facility prior to be in the presence of children in care. Failure to comply, requires an immediate civil penalty of $100 to $3000 per person, per incident.

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.

Beginning January 1, 2019 AB 2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families.
"Mandated Reporter" training for CA Child Care Providers that all staff are required to complete as of January 1, 2018. [Starting May 2019, both General Training followed by Child Care Providers Training is required to be taken]. The website for the online training is: http://www.mandatedreporterca.com/training/childcare.htm.

CONTINUED ON NEXT PAGE

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: RIVAS VALDEZ, MARCOS	FACILITY NUMBER: 013423559
	VISIT DATE: 12/14/2021

NARRATIVE

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The applicant was 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. The applicant was reminded of the responsibility as a mandated reporter. The applicant has provided proof that the required mandated reporter training was completed.

The applicant was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates. The applicant was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet.

This home is recommended for capacity increase.

Exit interview conducted.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: RIVAS VALDEZ, MARCOS	FACILITY NUMBER: 013423559
	VISIT DATE: 12/14/2021

NARRATIVE

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CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

· NEW LAW: Safe Sleep Regulations: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

· Licensees and all staff are Mandated Reporters and are required to report to CCLD any suspected child abuse.

CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov

Website for provider resources:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

childcareadvocatesprogram@dss.ca.gov

The Home is Recommended for Capacity Increase

Exit Interview was conducted, where this report was reviewed and discussed with Licensee. Report was signed by the Licensee confirming receipt of documents.

A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

END OF REPORT

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021

LIC809 (FAS) - (06/04)

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