214005139-5-8-2019-05-CC-FBTQ-BBYR7K-20190508124629

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005139
Report Date: 05/08/2019
Date Signed: 05/08/2019 12:46:35 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	ARTEAGA, AURORA ELVIRA		FACILITY NUMBER:	214005139
ADMINISTRATOR:	ARTEAGA, AURORA E.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 328-0187
CITY:	NOVATO	STATE: CA	ZIP CODE:	94947
CAPACITY:	14	CENSUS: 8	DATE:	05/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Aurora Elvira Arteaga		TIME COMPLETED:	11:45 AM

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) Farhan Bashir-Tariq met with the Licensee Aurora Arteaga to conduct an Annual Random inspection. The purpose of the visit was explained. Present there were 8 children in care with the Licensee, Licensee's Husband and a Helper. Licensee is operating within the capacity and ratio limit as of today 5/8/19. All adults living or working in the home have Background Check Clearance on file. Licensee rents the house which is a 4 bedroom and 2 bathroom home. LPA and Licensee inspected the Day care area for health and safety hazards. The operation hours are M-F, 8AM-5PM. Licensee provides Breakfast, Lunch and 2 snacks. LPA observed no bodies of water on the premises, per licensee there are no firearms or weapons on the premises. Chemicals and cleaning supplies are kept in the garage, an off limits area for the children. Off limits areas are kept inaccessible to children by use of baby gates. LPA observed that the fireplace is barricaded off and in the off limits area of the home. Facility is equipped with a smoke detector, a carbon monoxide detector, and a fully charged fire extinguisher that meets minimum size requirements. The home is kept clean and orderly, there are a sufficient amount of play materials and furniture for the children. Licensee presented a current roster of children, a current log of fire drills performed (last drill was performed in March 15, 2019), and all posting requirements are met. Children's files and adult files were reviewed. Children's files are current and complete. Adult files are complete with immunization records and first aid and CPR certification. Licensee holds the current and valid First Aid and CPR certificate which expires on October 23, 2020. LPA reminds the Licensee that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA observed the record of immunization of each present helper. As of January 1, 2018, all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online awww.mandatedreporterca.com. LPA observed the training completion certificates for the Licensee and all the staff. Continuation on next page...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ARTEAGA, AURORA ELVIRA	FACILITY NUMBER: 214005139
	VISIT DATE: 05/08/2019

NARRATIVE

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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
Applicant was reminded about the Provider Information Notices (PINs) on the CCLD website.
A copy of A Child Care Provider’s Guide to Safe Sleep Sheet was provided to the Applicant
LPA encourage the facility to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Facility can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

>No deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

>This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit.
Licensee was advised for any additional questions to call Office, M-F, 8AM-5PM at 650-266-8800 . For Rules and Regulations, visit the Website: www.cdss.ca.gov

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

LIC809 (FAS) - (06/04)

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