073408855-6-16-2021-02-CC-PPEN-C42UFS-20210616153314

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408855
Report Date: 06/16/2021
Date Signed: 06/16/2021 03:33:37 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:	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: 4	DATE:	06/16/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Marilu Garcia		TIME COMPLETED:	03:35 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	Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced annual site inspection for this facility at 2:25PM. LPA met with licensee, Marilu Garcia, and licensee's husband, Victor Garcia, who were both present along with licensee's mother in law, Teresa Gonzales, and four children in care. Two of the children in care were preschoolers and two were school age. The facility is within ratio and capacity and all adults present were background cleared and associated to this facility. The on limits areas for children in care are the living room, the day care room, and the hall bathroom on the main level and the converted garage. The off limits areas are the entire lower level of the home, the kitchen, the dining area and the family room. Off limits areas are made inaccessible by child safety gating including gating at the top of the stairs. The fireplace is screened for safety. There is child safety gating at the stairs. There are no hazardous items/toxins observed to be accessible to children in care. The facility has multiple working carbon monoxide detectors, working smoke detectors and a fully charged 2A10BC fire extinguisher. The front of the house outdoor area is on limits to children in care with adult supervision present 100% of the time children are using the area. There are no pieces of high climbing equipment or swings present at this facility. There are no pools, hot tubs or other accessible bodies of water. Per licensee there are no firearms present or stored on the premises. Continued on Page 2***************************************************************************************************

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 368-2672
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

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: 06/16/2021

NARRATIVE

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Children's files were reviewed for immunization records, identification and emergency information forms and parent's rights forms.

Facility records were reviewed for provider immunization records and mandatory reporter training certificates. The facility roster is current and all required postings are present. Licensee's CPR/First Aid is current with expiration in 01/2023.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information 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 is encouraged to visit www.ccld.ca.gov for licensing regulations and forms. Licensee is reminded that the mandatory reporter training is required to be renewed every two years for all providers of child care. To sign up for quarterly updates contact: childcareadvocatesprogram@dss.ca.gov.

No deficiencies were cited during today's inspection. LPA printed and provided a Notice of Site Visit which is to remain posted for a period of 30 days. A copy of this report was also provided and is to remain in the facility records and available for review for a period of three years.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 368-2672
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

LIC809 (FAS) - (06/04)

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