073407834-4-19-2023-02-CC-MSUN-CR2TUV-20230419150258

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073407834
Report Date: 04/19/2023
Date Signed: 04/19/2023 03:03:07 PM

Document Has Been Signed on 04/19/2023 03:03 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:	GORRIO, MARIA		FACILITY NUMBER:	073407834
ADMINISTRATOR:	GORRIO, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 265-8632
CITY:	CONCORD	STATE: CA	ZIP CODE:	94519
CAPACITY:	14	CENSUS: 10	DATE:	04/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Dora Gorrio Lizarrag		TIME COMPLETED:	03:15 PM

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On 4/19/23 at 1:50 PM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Annual inspection Maria Gorrio Family Childcare Home. LPA met with assistant/daughter Dora Gorrio Lizarrag and explained the purpose of today's inspection. Licensee is currently out of town. The family childcare home days and hours are Monday to Friday 7:00 AM to 6:00 PM. Present in the home at time of inspection were 3 adults associated to the facility, 2 infants and 8 preschool children.

Facility Representative 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: A health and safety tour of inside the home was done. LPA toured the premises and the home is sanitized and orderly in compliance with Title 22 Regulations at this time. There is a 3A40BC fire extinguisher, smoke alarm and carbon monoxide detector in the home.

The OFF-LIMIT These areas are inaccessible to children in care by closed locked doors and visual supervision. IN-USE Living room, kitchen, hallway bathroom, left side of backyard and bedroom 1, which facility is currently not using are the primary areas for day care. Medicines, cleaning products, sharp objects are stored inaccessible to children. LPA reminded facility that baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. Facility states that there are no pets and no arms and ammunition stored in the home. The fireplace is screened, and the home maintains a working telephone.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle Sutton	TELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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: GORRIO, MARIA	FACILITY NUMBER: 073407834
	VISIT DATE: 04/19/2023

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Outdoor Space: LPA toured the outdoor area (backyard) and observed it was fully fenced. Facility only operated on the left side of the yard. LPA observed there are no pools, hot tubs or other bodies of water.

Children files and Facility files were reviewed. Facility contained Children's Roster, Facility's representative mandated reporter training expires 1/30/25, pediatric CPR and first aid expires 11/11/23. LPA did not conduct the staff interview today.

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

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

There are no deficiencies cited during today's inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative Dora Gorrio Lizarrag.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle Sutton	TELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

LIC809 (FAS) - (06/04)

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