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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073407727
Report Date: 10/09/2019
Date Signed: 10/09/2019 12:11:56 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:QUINTANA, REBECAFACILITY NUMBER:
073407727
ADMINISTRATOR:QUINTANA, REBECAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 962-1787
CITY:EL CERRITOSTATE: CAZIP CODE:
94530
CAPACITY:14CENSUS: 14DATE:
10/09/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Rebeca QuintanaTIME COMPLETED:
12:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced case management site inspection for this facility at 0925. LPA met with licensee, Rebeca Quintana. Also present at the time of LPA's arrival were assistants, Patricia Munar and Maria Mandujano, one parent volunteer and 14 children in care consisting of one infant and 13 preschool age children. Names and birth dates of children were recorded. The facility is over capacity.

California Code of Regulations, Tittle 22 is being cited on the attached LIC 9099D for a Type A violation. This citation must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled in the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC 9224). The LIC 9224 must be placed in the child’s file to be reviewed by licensing.

An exit interview was conducted and a copy of the appeal rights provided. This is a repeat violation and so a civil penalty is being assessed. A notice of site visit was printed and is to remain posted for 30 days and a copy of this report is to be available in the facility records for a period of three years.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
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: QUINTANA, REBECA
FACILITY NUMBER: 073407727
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/09/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/10/2019
Section Cited

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102416.5(d)(2) A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met: (a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age. This Facility
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was not in compliance with this requirement as evidenced by the presence of one infant and 13 preschool age children during this inspection posing a risk to the health and safety of children in care. This is a repeat violation within a one year period.
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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: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2019
LIC809 (FAS) - (06/04)
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