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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408794
Report Date: 11/23/2020
Date Signed: 02/17/2021 03:28:31 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:GARRIDO, LARISSAFACILITY NUMBER:
073408794
ADMINISTRATOR:LARISSA GARRIDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 771-2494
CITY:RICHMONDSTATE: CAZIP CODE:
94806
CAPACITY:14CENSUS: 11DATE:
11/23/2020
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Larissa GarridoTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Paul Petersen conducted a case management site visit for this facility via tele-visit. LPA met with licensee, Larissa Garrido. Also present at the facility was licensee's husband and eleven children in care.

LPA and licensee reviewed a recent interaction between licensee's husband and one of licensee's neighbors. There were no deficiencies cited during this case management visit. A copy of this report was provided to licensee along with the appeal rights. The report is to remain in the facility file for a period of three years.

"This is an amended version of the original report dated 11-23-2020."
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2020
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: GARRIDO, LARISSA
FACILITY NUMBER: 073408794
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/23/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
12/08/2020
Section Cited

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102423(a)(2)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:
(2) To receive safe, healthful, and
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comfortable accommodations, furnishings, and equipment. This facility was in violation of this requirement as evidenced by an incident involving licensee's husband loudly telling a neighbor to "shut up" repeatedly while children in care were present thereby posing a potential risk to the health and safety of children in care.
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https://ccld.childcarevideos.org/family-child-care-providers . Licensee will submit a dated declaration of completion of this requirement, signed by all adult providers by the POC date. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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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: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 11/23/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/23/2020
LIC809 (FAS) - (06/04)
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