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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005348
Report Date: 08/29/2019
Date Signed: 08/29/2019 03:13:07 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: 5DATE:
08/29/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Mariangela De OliveiraTIME COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Van and Licensing Program Manager (LPM) Leung met with licensee, Mariangela De Oliveira, for an announced inspection of Plan of Correction (POC). The purpose of the inspection was explained and was granted entry to the home by licensee. Present, there are 5 children (all 5 children are infants) in care with licensee.

On three different inspections May 16, June 26, and July 23, the facility was operating out of ratio. On July 23, 2019 inspection, this facility received a repeat violation deficiency and was assessed civil penalty. In today's POC inspection, LPAs inspected the facility for health and safety hazards to verify the correction of the previous deficiencies.

At 1:30 P.M., LPAs observed two rock 'n play sleepers in the day care area. LPAs reminded licensee that rock 'n play equipment are not allowed at the day care area. Licensee was immediately removed the equipment to an off-limit area. Children records were reviewed and confirmed that licensee was again operating out of ratio and did not maintain a proper ratio that was discussed on May 16, June 26, and July 23.

A civil penalty of $250 was assessed today for failure to correct the deficiency that was cited on 7/23/19. The Civil penalty continues to accrue at $100 per day until the deficiency is corrected.

An exit interview was conducted with licensee. A copy of this report is reviewed and provided to the licensee. LPM notified licensee that An office meeting may be scheduled. Facility will be notified of time and date of office meeting.

Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: 08/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/29/2019
Section Cited

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102417 Operation of a Family Child Care Home. (d)The home shall provide safe toys, play equipment and materials. This requirement is not met as evidenced by:
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Based on LPAs observation, licensee has two rock 'n play sleepers in the day care premise, this poses a potential 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: 08/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: 08/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/30/2019
Section Cited

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102416.5 - 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
continue below....................
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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. This requirement is not met as evidenced by LPA records reviewed and observed 5 infants in care. This poses an immediate health and safety risk to children in care.
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By 8/30/2019, Licensee will need to reduce the infant ratio to 4, and will operate within ratio. An office meeting may be scheduled.
Facility will be notified of time and date of office meeting. Licensee states C3 will be leaving tomorrow. Licensee provided a letter from C3 parents stated 8/30 will be his last day.

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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: 08/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3