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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405891
Report Date: 06/15/2022
Date Signed: 06/15/2022 04:49:56 PM


Document Has Been Signed on 06/15/2022 04:49 PM - It Cannot Be Edited

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:MORENO, MARIA A.FACILITY NUMBER:
073405891
ADMINISTRATOR:MORENO, MARIA A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 431-0610
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY:14CENSUS: 11DATE:
06/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Maria MorenoTIME COMPLETED:
04:50 PM
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On 6/15/22 at 3:10 PM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Annual inspection at Maria Moreno Family Childcare Home. LPA met with licensee and explained the purpose of today's inspection. LPA was granted the inspection authority to enter the Home. The family childcare home days and hours are Monday to Friday 6:00 AM to 6:00 PM. Present in the home at time of inspection were licensee, licensee's spouse, licensee son, assistant and 11 children.

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.

Indoor Space: At 3:20 PM A health and safety tour of inside the home was done. LPA toured the premises with licensee. There is a 3A40BC fire extinguisher, working smoke and carbon monoxide detector in the home. The home is a single story house that consists of three bedrooms and two bathrooms. The OFF LIMIT AREAS are the master bedroom and bathroom, the garage and the entire backyard which is inaccessible by gate, closed and/or locked doors and visual supervision. The ON LIMIT AREAS are the living room which is the main area of the day care, the kitchen, dining room, family room, the first two bedrooms on the right side of the hallway and the hallway bathroom. Medicines, cleaning products, sharp objects are stored inaccessible to children in cabinets and draws with latches. LPA reminded licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare home. Licensee states that there is 1 dog. No arms and ammunition stored in the home. The fireplace is screened and the home maintains a working telephone.

Licensee and assistant files were reviewed. Children files were not reviewed and staff interview was not completed. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Maria Moreno.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle SuttonTELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:
DATE: 06/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2022
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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