073406012-11-19-2019-02-CC-THAR-BJ3THL-20191119134456

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073406012
Report Date: 11/19/2019
Date Signed: 11/19/2019 01:45:02 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:	BRAVO, DANITZA		FACILITY NUMBER:	073406012
ADMINISTRATOR:	BRAVO, DANITZA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 757-5987
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94509
CAPACITY:	14	CENSUS: 4	DATE:	11/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	DANITZA BRAVO		TIME COMPLETED:	02:00 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	LPA Tasha Alexander met with licensee Danitza Bravo for an unannounced ANNUAL/RANDOM inspection. Present for the inspection were licensee, her mother Maria Delcarpio and 4 children in care, consisting of 3 preschoolers and 1 school-age. LPA toured the facility and backyard for a health and safety inspection. The children's files contained emergency information and immunization blue cards. The home is equipped with a 3A40BC fire extinguisher, working smoke detector and working carbon monoxide detector. There is a working telephone in the home. Per licensee there are no fire arms on the premises. There are There is a pond/waterfall located in the backyard that is surrounded by 5ft self latching fence that meets the state fire marshal standards. All poisons, cleaning solutions and medications are inaccessible to children. Licensee has current CPR and 1st Aid training which expires 6/2020 respectively. The off limits areas are entire upstairs, laundry room and garage. Licensee was also informed of the licensing web address (www.ccld.ca.gov) for downloading child care forms and (www.myccl.com) to register to receive child care updates. A review of staff records on 11/19/19 indicates that all facility staff or other individual who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. Effective September 1, 2016 a person may not work or volunteer at a child care center or family child care home unless he or she has been vaccinated against pertussis, measles and influenza or has an exemption. Licensee is and mom/assistant both have immunization records in file today. Both are up to date on flu vaccine. Today the newly implemented Mandated Reporter training course has been discussed. Licensee completed the training 3/30/18. The new safe sleep practices for infants was also discussed today. Licensee is not currently caring for infants. There are 4 play pens available for napping.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019

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: BRAVO, DANITZA	FACILITY NUMBER: 073406012
	VISIT DATE: 11/19/2019

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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 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

As a result of this visit, there are no deficiencies cited today. This report must be available for public review for 3 years. An exit interview was conducted. A notice of site visit was posted.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019

LIC809 (FAS) - (06/04)

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