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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423564
Report Date: 10/29/2021
Date Signed: 10/29/2021 12:05:04 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:TORREZ, MILCAHFACILITY NUMBER:
013423564
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
10/29/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Milcah TorrezTIME COMPLETED:
12:20 PM
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On 10/29/2021, Licensing Program Analysts (LPAs), Melissa Guirit and Melissa Domantay conducted an in-person case management/increase in capacity inspection. Present during today's inspection were the licensee and five preschool aged children. The entire home was toured to conduct a health and safety inspection with the licensee. Hours of operation for day care are Monday through Friday 8:30am to 5:00pm.

Community Care Licensing (CCL) has received an approved fire clearance on 08/30/21 by the Oakland Fire Department.

The home is a 2 story house which is neat and clean with heating and ventilation for the safety and comfort of the children. The home consists of living room, dining room, three bedrooms, kitchen, two full bathrooms, attic, basement, and backyard. The on limits areas are the Living room, bathroom at the end of the hallway, dining room, all three bedrooms, deck area, and backyard. All three bedrooms and entire back yard has been added to licensee's on limit areas. Both areas were inspected by LPAs to conduct a health and safety inspection. The off limits area are attic, basement, and bathroom next to washer and dryer. Off limit areas will be made inaccessible by use of gates, closed and/or locked doors and visual supervision. There are age appropriate toys in the home. The isolation are will be in the living room on the couch. The fireplace is blocked to prevent access by children in care. Per licensee, there are no firearms in the home. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection.

The home has a fully charged 3A40BC fire extinguisher, working combo smoke detector and carbon monoxide detector, first aid supplies and working telephone.

See 809-C for continuance.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa GuiritTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2021
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: TORREZ, MILCAH
FACILITY NUMBER: 013423564
VISIT DATE: 10/29/2021
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The applicant’s CPR and First Aid certificate is current and expires 01/12/2022. Licensee's Mandated Reporter training certificate is current and expires 12/26/2021. Licensee is in compliance with immunization requirements. Safety precaution in regards to COVID-19 were discussed and posters were posted on front door.

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

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.

No deficiencies observed at this visit. The licensee is now approved for an increase in capacity to operate as a large family day care home.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Milcah Torrez

SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Melissa GuiritTELEPHONE: (510) 566-8898
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2021
LIC809 (FAS) - (06/04)
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