073405356-1-2-2020-02-CC-PPEN-BKFQ8V-20200102105723

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073405356
Report Date: 01/02/2020
Date Signed: 01/02/2020 10:57:30 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:	ALVAREZ, LIGIA & ROBERTO		FACILITY NUMBER:	073405356
ADMINISTRATOR:	ALVAREZ, LIGIA & ROBERTO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 234-8332
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94805
CAPACITY:	14	CENSUS: 5	DATE:	01/02/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Ligia and Roberto Alvarez		TIME COMPLETED:	11:05 AM

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 0920. At arrival, LPA met licensees, Ligia and Roberto Alvarez, in the downstairs childcare area of the residence and also present at the time were three children in care. Two additional children in care arrived while LPA was present for a total of five children in care consisting of one infant and four preschool age children. Also present in the upstairs non-childcare area of the residence was licensee's son, Andre Alvarez. All adults present are background cleared and associated to this facility. The facility is within ratio and capacity. The areas on limits to children in care are the downstairs main day care room, downstairs bathroom, downstairs kitchen and dining area and downstairs nap room. Off limits areas are made inaccessible by closed doors or child safety gating and visual supervision. There is child safety gating at the base of the stairs and the downstairs fireplace is screened to prevent access. The facility is clean and organized with heating and ventilation for comfort. There are age appropriate furnishings, play items and equipment, including infant sleeping equipment, which are free of observed hazardous conditions. The facility has a working carbon monoxide detector, working smoke detector and more than one fully charged 3A40BC fire extinguishers. Per licensee there are no firearms present or stored on the premises. The outdoor patio/deck area and the lower outdoor play/swing area are both on limits to children with adult supervision present at all times children are using the area. There is one piece of high climbing equipment/swings present in the lower play area which is securely anchored and has cushioning under/around the equipment. The outdoor areas are fully fenced. There are no pools, hot tubs or other bodies of water accessible to children in care. 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: 01/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2020

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: ALVAREZ, LIGIA & ROBERTO	FACILITY NUMBER: 073405356
	VISIT DATE: 01/02/2020

NARRATIVE

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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

LPA reviewed the facility, staff and children's records including parents' rights forms, emergency ID forms and consent form emergency medical treatment. Licensee and licensee's husband have current CPR/First Aid certification which expire 10/2020. All required postings are present. 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. To sign up for quarterly updates contact: childcareadvocatesprogram@dss.ca.gov.

There were no deficiencies cited during this inspection. A notice of site visit was printed and posted and is to remain posted for 30 days. A copy of this report is to be kept and available for review in the facility records for 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: 01/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2020

LIC809 (FAS) - (06/04)

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