274415578-9-4-2019-07-CC-FCJO-BFPLGG-20190904084441

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274415578
Report Date: 09/03/2019
Date Signed: 09/04/2019 08:44:51 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	MARQUEZ-GARCIA, VERONICA & CONWAY, ROBERT		FACILITY NUMBER:	274415578
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	09/03/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Veronica Marquez-Garcia		TIME COMPLETED:	12:00 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) Fermin Campos-Jaramillo conducted an announced pre-licensing inspection to the home today. LPA met with Veronica Marquez, Applicant, and explained the nature of today's inspection to her. The adults that reside in the home are the applicant and her spouse and co-applicant Robert. Also in the home reside applicant's minor children ages 7 and 6 years old. Days and hours of operation will be Monday to Sunday from 4:00 AM to 3:00 AM. Applicant understands that the children cannot stay in the home for more than 24 continue hours. Applicants have completed the Preventative Health and Safety Child Care Training on 9/10/2016 and 10/22/16 respectively. Applicants's CPR and First Aid certifications are current and will expire on 11/07/2020 and 10/19/2020 respectively. Applicants rent the home and a copy of the leasing agreement will be submitted to Licensing Department. Applicant states will use the affidavit regarding liability insurance for child care providers. LPA toured the indoor and outdoor areas during today's inspection. LPA observed the home has a wall heater in the off limits part of the home. Applicant understands the wall heater must have to be made inaccessible to children. Off limit areas inside the home: Three bedrooms, the laundry area located in a closet, the garage, and one bathroom. LPA observed a fully charged 2A10BC fire extinguisher and at least one working smoke detector. LPA observed the home has at least one working carbon monoxide detector. Off limits out door areas are: One storage shed located in the back yard. LPA observed there are not bodies of water. LPA observed the home does not have stairs. Applicant's will use the back yard as playground for the children in care. LPA observed the home has a barricaded fireplace in the on limits day care area. Applicant states that there are no weapons in the home. Applicant understand that cleaning products, toxic agents, medications, and sharp objects shall not be accessible to children. LPA reminded applicant that smoking, baby walkers, bouncers, jumpers, and similar items are not allowed in Family Child Care Homes. A review of staff records on 8/29/2019 indicates that all adults residing in the home or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. ******************* Report dated 9/03/2019 continues in page 2 *************

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MARQUEZ-GARCIA, VERONICA & CONWAY, ROBERT	FACILITY NUMBER: 274415578
	VISIT DATE: 09/03/2019

NARRATIVE

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Report dated 9/03/2019 continues from page 1.
LPA reminded Applicant of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.
Forms of discipline applicant will use: Communication with children and redirection. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed. LPA informed applicant that fire/disaster drills must be practiced at least once every 6 months and documented. A Family Child Care Home packet with updated Licensing forms was provided to and reviewed with the applicant. Department website: www. ccld.ca.gov provided to applicant. LPA discussed the requirements of AB 633 with the applicant. LPA also discussed "zero tolerance" related regulations with the applicant. LPA observed proof of immunization for measles, pertussis and influenza (opt out) are in file for applicant. 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. LPA advised applicant about the "mandated reporter" training AB1207, mandatory for all Licensees and all the adults in contact with children. LPA referred the Applicant to the Department website: www.ccld.ca.gov and www.mandatedreporterca.com for additional information. LPA advised applicant of the pending Department regulation update re: safe sleep for infant children. LPA referred the applicant to the Department website: www.ccld.ca.gov and
LPA conducted an exit interview with the applicant and advised her that a small FCCH license will be approved pending on the following: 1) Applicant will make inaccessible the three bedrooms and the hallway placing a fence, 2) applicant will submit a copy of the signed leasing agreement, 3) applicant will submit two signed letters for relocation in the event of a disaster, 4) Applicant will submit a signed form LIC9149-Property landlord consent, and 5) Approval from a manager of the Licensing Department.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

LIC809 (FAS) - (06/04)

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