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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005348
Report Date: 05/16/2019
Date Signed: 05/16/2019 01:18:38 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:DE OLIVEIRA, MARIANGELAFACILITY NUMBER:
214005348
ADMINISTRATOR:DE OLIVEIRA, MARIANGELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 368-8713
CITY:CORTE MADERASTATE: CAZIP CODE:
94925
CAPACITY:14CENSUS: 8DATE:
05/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:De Oliveira MarianggelaTIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Van performed an unannounced random annual inspection at the above facility. LPA met with licensee Mariangela De Oliveira, the purpose of the inspection was explained. Present at the home are licensee, her daughter, 1 aide and 8 children (5 are infants, 3 preschool). The facility is operating within licensed capacity and within ratio on this day. LPA inspects inside of the facility for health and safety hazards. Hours of operations are Monday – Friday from 7:30AM – 5:30PM. Day-care areas are: living room, bedroom, the bathroom, the outdoor backyard. Off Limit areas are: two bedrooms next to the bathroom, and kitchen. Licensee states that sick children will be separated from the group and will be waiting in the bedroom for parents to pick up.

LPA did not observe any bodies of water on the facility. Per licensee there are no firearms or weapons in the home. Fireplace is barricaded and is inaccessible to children in care. Cleaning supplies and chemicals are inaccessible to children, they are stored under the kitchen sink and locked away with child proof locks. The home is equipped with a carbon monoxide detector, a smoke detector, and a fully charged fire extinguisher that meets minimum size requirements. The home is clean and in well repair. There are sufficient amounts of age appropriate furniture, toys and reading materials available to children. There are an adequate lightning, ventilation, and comfortable temperature in the home.

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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2019
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: DE OLIVEIRA, MARIANGELA
FACILITY NUMBER: 214005348
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/17/2019
Section Cited
CCR
102416.5(d)(1)
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CCR 102416.5(d)(1) ) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: Twelve children, no more than four of whom may be infants.
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By 5/17/2019, Licensee will be operating within ratio. Licensee stated that she will talk to the parents to arrange the day care for the infants. Licensee will provides LPA children schedule and children rosters.
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This requirement is not met as evidenced by LPA observed 5 infants in care. This poses an immediate health and safety risk to children in care.
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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: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2019
LIC809 (FAS) - (06/04)
Page: 1 of 1
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: DE OLIVEIRA, MARIANGELA
FACILITY NUMBER: 214005348
VISIT DATE: 05/16/2019
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LPA reviewed children’s and staff’s files. Children files had immunization records and signed parent’s rights notification forms. First Aid/CPR certification is presented. Licensee First Aid and CPR expired on 4/21. licensee had immunization records on file. Discipline policy was discussed. Licensee states her discipline method will be talking to the child, redirection and finally ending with time-out. LPA reminds licensee that for time-out, one minute per child’s age, and no more than 5 minutes).

LPA reminds 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.

LPA reviews AB 1207 with the licensee. As of January 1, 2018, all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA also reminds licensee conduct fire drill/earthquake drill once every six months, and to log the date & time of each drill.

A Type “A” violation was issued today. The facility is informed to provide a copy of the Evaluation Report and the Type “A” Deficiency cited to the parents and guardians of children currently enrolled in care and to parents of newly enrolled children during the next 12 months. A signed and dated LIC 9224 shall be maintained in all Children's files. This report and appeal rights were provided and reviewed with the licensee. Notice of Site Visit shall remain posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2019
LIC809 (FAS) - (06/04)
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