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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406676
Report Date: 06/24/2022
Date Signed: 06/24/2022 03:09:20 PM

Document Has Been Signed on 06/24/2022 03:09 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:ICRI/EL NUEVO MUNDO CHILDRENS CENTERFACILITY NUMBER:
073406676
ADMINISTRATOR:SILVANA MOSCA-CARREONFACILITY TYPE:
850
ADDRESS:1707 PENNSYLVANIA AVE.TELEPHONE:
(510) 233-2329
CITY:RICHMONDSTATE: CAZIP CODE:
94801
CAPACITY: 97TOTAL ENROLLED CHILDREN: 97CENSUS: 18DATE:
06/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:54 AM
MET WITH:Maria ZalduaTIME COMPLETED:
03:23 PM
NARRATIVE
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On Friday, June 24, 2022 at 9:54 AM, Licensing Program Analyst (LPA) Caroline Colson, arrived at the facility and met with Maria Zaldua, Administrative Assistant, to conduct an annual required inspection. A Health and Safety Inspection was conducted. The hours of operation are Monday - Friday from 8:00 AM to 4:30 PM. LPA made the following observations:

Capacity/Staffing: There are 18 preschool children and 7 staff members including acting director, Dora Rosa-Castillo.

Physical Plant: There are five classrooms for the entire Preschool Program. All bathrooms were inspected. There is adequate heating, lighting and ventilation. There are no cleaning solutions, chemicals or other hazards accessible to children.

Classrooms: Furniture and equipment age appropriate and in good repair. There are separate storage areas for children’s belongings. Children nap at the facility. There are cots and bedding materials for the children. Bedding materials are washed every week by the facility. The menu is posted for review.

Restrooms: Toilets and sinks are operable. There is soap, toilet paper and paper towels for sanitary use.

Play yard: Climbing structures, slides are safe and in good condition. Playground is free of debris and other hazards. Drinking water is readily available. There are no pools, hot tubs or other bodies of water present.

Please LIC 809 C for additional information
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2022
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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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: ICRI/EL NUEVO MUNDO CHILDRENS CENTER
FACILITY NUMBER: 073406676
VISIT DATE: 06/24/2022
NARRATIVE
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Emergency Preparedness/Safety: Smoke detector was inspected and is working. Carbon monoxide detector was tested and is working. There is a 2A10BC fire extinguisher and was serviced in February 2021. Pediatric CPR and First Aid Certificates are current and expire on March 16, 2023. Mandated Reporter Training Certificate expires on April 22, 2023. First Aid Kit is available and complete. Emergency Disaster Plan is posted. The facility utilizes a land line telephone.

Postings: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist and a waiver is located in the main office.

Sign in Sheet/Class Roster: All parents use electronic signatures to sign in and sign out. The roster is current and available.

Training/Record Review:
All staff present on this date have criminal background clearances. Immunization records are on file.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Maria Zaldua was reminded that all adults 18 and over, 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 Child Care Center. 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.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022
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: ICRI/EL NUEVO MUNDO CHILDRENS CENTER
FACILITY NUMBER: 073406676
VISIT DATE: 06/24/2022
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee's representative, Maria Zaldua.

Please See LIC 809 D for Deficiencies. The attached type B deficiencies are being cited today and must be corrected by the due date.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/24/2022 03:09 PM - It Cannot Be Edited


Created By: Caroline Colson On 06/24/2022 at 02:10 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ICRI/EL NUEVO MUNDO CHILDRENS CENTER
FACILITY NUMBER: 073406676

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above because S3 doesn't have a health history report on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/24/2022
Plan of Correction
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S3 will have a health screening completed and submit to the department by due date.
Type B
Section Cited
CCR
101217(a)(12)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (12) Tuberculosis test documents as specified in Section 101216(g).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above because S3 doesn't have a TB clearance on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/24/2022
Plan of Correction
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S3 will obtain a TB clearance and submit the vaccination record to the department by due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mayla Mendoza
LICENSING EVALUATOR NAME:Caroline Colson
LICENSING EVALUATOR SIGNATURE:
DATE: 06/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2022


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