073405064-1-22-2020-02-CC-PPEN-BL3S9U-20200122124120

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073405064
Report Date: 01/22/2020
Date Signed: 01/22/2020 12:41:28 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:	VILLANEDA, MARIA		FACILITY NUMBER:	073405064
ADMINISTRATOR:	VILLANEDA, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 223-2747
CITY:	EL SOBRANTE	STATE: CA	ZIP CODE:	94803
CAPACITY:	14	CENSUS: 10	DATE:	01/22/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Maria Villaneda		TIME COMPLETED:	12:45 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	Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced random annual site inspection for this facility at 1110. LPA met with licensee, Maria Villaneda, who was present along with assistant, Christina Lorenzana Garce, and 10 children in care consisting of four infants and six preschoolers. The facility is within ratio and capacity and all adults present are background cleared and associated to this facility. The on limits areas for children in care are the day care room, the office, the kitchen and the children's bathroom. All on limits areas were inspected for a health and safety inspection. Off limits areas are made inaccessible by child safety gating or closed doors and visual supervision. The facility is clean and orderly with heating and ventilation available for comfort. There are no hazardous items/toxins observed to be accessible to children. Furnishings and equipment, including infant sleeping equipment, are age appropriate and free of observed hazardous conditions. There is a working smoke detector, working carbon monoxide detector and fully charged 3A40BC fire extinguisher. Per licensee there are no firearms stored or present on the premises. There is one pet dog and one pet bird. The outdoor patio/play area is fully fenced and on limits to children in care. The separate storage and exercise areas of the patio are off limits to children in care. There are no pieces of high climbing equipment or swings present. There are no pools, hot tubs or accessible bodies of water present. Personnel records were reviewed for immunization records and CPR/First Aid certification. Licensee and assistant have current CPR/First Aid certification which expires in 2021. Continued on Page 2*************************************************************************************

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020

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: VILLANEDA, MARIA	FACILITY NUMBER: 073405064
	VISIT DATE: 01/22/2020

NARRATIVE

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Children's records were reviewed for parents' rights forms, identification and emergency information forms and immunization records.

All required postings are present and the facility roster is up to date.

LPA reviewed with licensee the current Facility Personnel Report Summary and verified that all adults requiring background clearances are cleared and associated to this facility.

The Safe Sleep Awareness Campaign PIN packet was provided and reviewed. Licensee is encouraged to visit www.ccld.ca.gov for licensing regulations and forms. Licensee is reminded that the mandated reporter training is required to be renewed every two years for all child care providers. To sign up for quarterly updates contact: childcareadvocatesprogram@dss.ca.gov.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information 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

There were no deficiencies cited during this inspection. A notice of site visit was provided and is to be posted for 30 days. A copy of this report is to remain in the facility records and available for review for a period of three years from today's date.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020

LIC809 (FAS) - (06/04)

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