073408855-8-17-2022-02-CC-NBLT-CHDR36-20220817123926

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408855
Report Date: 08/17/2022
Date Signed: 08/17/2022 12:39:36 PM

Document Has Been Signed on 08/17/2022 12:39 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:	GARCIA, MARILU		FACILITY NUMBER:	073408855
ADMINISTRATOR:	GARCIA, MARILU		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 207-2137
CITY:	RICHMOND	STATE: CA	ZIP CODE:	94803
CAPACITY:	14	CENSUS:	DATE:	08/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	GARCIA, MARILU		TIME COMPLETED:	01:00 PM

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On August 17, 2022 at 10:00 AM, Licensing Program Analyst (LPA) Nyeesha Blount met with Licensee Garcia, Marilu who is background cleared for an unannounced random annual inspection. There are (4) preschool children present during the time of the inspection. the facility operating hours are Monday -Sunday 6:00 AM to 6:00 PM. LPA toured all on limits areas of the facility for health and safety inspection. all required postings are posted in the entry of the day care room on the wall.

The home is two story consists of an (2) living room, dining room, kitchen, (5) bedrooms, (3) bathrooms, fenced balcony, day care room. the home is neat and clean and has central heating and ventilation for safety and comfort. There is sufficient amount of age appropriate furnishings, toys, books and learning materials available. Licensee states that there are no weapons in the home. the fireplace is screened for safety, All hazardous materials and toxins are stored away inaccessible to children in care at the time of the inspection .The home is equipped with a fully charged 4A80BC fire extinguisher in the day care room and fully charged 3A40BC fire extinguisher in kitchen, working smoke detector and working carbon monoxide detector. Pediatric CPR and First Aid are current and will expire on January 2023.

ON LIMIT areas of the home will be the first living room to the left, day care room, hall bathroom

OFF LIMIT areas of the home will be the (1) bedroom upstairs, kitchen, second living room, dining room,the entire lower level of the home secured with a locked glass door made inaccessible to children in care.

Outdoor Space: The front of the home is the outdoor area to children in care with adult supervision present at all times. .

Isolation Area : will be in the living room.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Nyeesha Blount	TELEPHONE: (510) 566-2319
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

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: GARCIA, MARILU	FACILITY NUMBER: 073408855
	VISIT DATE: 08/17/2022

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LPA reviewed the facility staff and children's records including parents' rights forms, emergency ID forms and consent for emergency medical treatment forms. Licensee CPR/First Aid, Mandated Reporter Certificate for Licensee is all up to date.

LPA discussed the safe sleep regulations with licensee 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 licensee 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 firearms stored or present in the home.

Per 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

Licensee 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.

Licensee was reminded about importance to stay in compliance with mandated reporter training and maintenance of sleep logs for all infants in care. In the areas that were evaluated, no regulatory violations were observed.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Exit interview conducted and report was reviewed with the licensee GARCIA, MARILU.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Nyeesha Blount	TELEPHONE: (510) 566-2319
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

LIC809 (FAS) - (06/04)

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