073408145-7-18-2019-02-CC-THAR-BE7R8Z-20190718124847

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408145
Report Date: 07/18/2019
Date Signed: 07/18/2019 12:49:06 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:	SAAVEDRA, ANEL		FACILITY NUMBER:	073408145
ADMINISTRATOR:	SAAVEDRA, ANEL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 305-3369
CITY:	PITTSBURG	STATE: CA	ZIP CODE:	94565
CAPACITY:	14	CENSUS: 10	DATE:	07/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	MARISOL MORENO		TIME COMPLETED:	01:00 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's assistant Marisol Moreno for an unannounced ANNUAL/RANDOM inspection. Today Licensee is out of the country on an emergency. Present for the inspection is assistant Marisol, assistant Estella Rodriguez, Licensee's husband Roberto Huerta, their 14 year old son and 10 children in care, consisting of 2 infants, 6 preschoolers, and 2 school-age. LPA toured the facility and backyard for a health and safety inspection. The children's files contained emergency information immunization blue cards. The home is equipped with a 2A10BC 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 no pools, hot tubs, or other bodies of water at the home. All poisons, cleaning solutions and medications are inaccessible to children. Marisol has current CPR and 1st Aid training which expires 8/2019 respectively. The off limits areas are the entire upstairs which includes the laundry room, and the garage. Licensee was instructed that smoking, baby bouncers, exersaucers and baby walkers are prohibited in the facility during day care hours. Today there is a baby bouncer/rocker in the home being utilized by a 6 month old infant. 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 7/18/19 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. Today Marisol has record of pertussis vaccination. and Flu opt out letter. There is record of measles vaccination. CONTINUED ON 809-C

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019

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: SAAVEDRA, ANEL	FACILITY NUMBER: 073408145
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/18/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/19/2019 Section Cited CCR 102417(g)(10)(b)	1 2 3 4 5 6 7	102417 Operation of a Family Child Care Home (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Section 1596.846(b) and (c). (b) A baby walker shall not be kept or used on the premises of a child day care facility. REQUIREMENT WAS NOT MET: TODAY THERE IS A BABY BOUNCER/ROCKER IN THE HOME UTILIZED BY AN INFANT	1 2 3 4 5 6 7	THIS ITEM WILL BE REMOVED FROM THE FACILITY BY THE END OF THE BUSINESS DAY.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019

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: SAAVEDRA, ANEL	FACILITY NUMBER: 073408145
	VISIT DATE: 07/18/2019

NARRATIVE

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The newly implemented mandatory mandated reporter training course was discussed today. Marisol has a certificate of completion in file dated 3/2019. Today we are unable to locate the licensee's certificate.

The new safe sleep practices for infants was also discussed today and the Safe sleep practices guidelines information/forms given. There are 2 infants present today. There are 2 play pens available for napping. Assistants have been instructed to remove the blankets from the play pens 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

The attached type B deficiencies are cited today and must be corrected by the due date. An exit interview was conducted. This report must be available for public review for 3 years. A notice of site visit was posted.

SEE 809-D FOR CITATION

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2019

LIC809 (FAS) - (06/04)

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