274415981-2-10-2021-07-CC-FCJO-BY4R8Y-20210210114842

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274415981
Report Date: 02/05/2021
Date Signed: 02/10/2021 11:48:50 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:	BONILLA, ZOILA		FACILITY NUMBER:	274415981
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	02/05/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Zoila Bonilla		TIME COMPLETED:	04:45 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 tele-visit to the home today. LPA agreed with applicant Zoila M Bonilla to tele visit her home via FaceTime. The adults that reside in the home are the applicant, and her adult daughter Estrella (present today during the tele visit) Also in the home reside applicant's minor children ages 16, and 12 years old. LPA observed there were not children in care present during the tele-visit. Days and hours of operation will be Monday to Friday from 7:30 AM to 5:30 PM. Applicant understands that the children cannot stay in the home for more than 24 continuous hours. Applicant have completed the Preventative Health and Safety Child Care Training on 1/23/2021. Applicant's CPR and First Aid certifications are current and will expire on 10/10/2022. Applicant rents the home and landlord consent form is in the Licensing Department's file. Applicant states does not have liability insurance and will use the affidavit regarding liability insurance for child care providers. LPA tele toured the indoor and outdoor areas during today's tele-visit. LPA observed the home has a two sided barricaded wall heater. Off limit areas inside the home: Room 1. Room 3, and room 4, the laundry room, and one bathroom in a hallway. LPA observed a fully charged 3A40BC fire extinguisher last time serviced on 1/29/21, and at least one working smoke detector. LPA observed the home has installed at least one working carbon monoxide detector. Off limits outdoor areas are: A storage shed in the back yard. LPA did not observe any bodies of water and the applicant stated there are not bodies of water in the premises. LPA observed the home is fenced. Applicant stated will use the rightside yard and part of the backyard as playground. LPA observed the home does not have stairs. LPA observed the home does not have a fireplace. Applicant states that there are no weapons in the home. LPA observed a big turtles tank which is placed on a table in the on limits living room. Applicant stated the tank is very heavy and it is not possible that a child can move it. LPA observed the tank has a lid and the lid is unreachable to the children. Applicant stated she does not have any other pets. ******************* Report dated 2/05/21 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: 02/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2021

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

FACILITY NAME: BONILLA, ZOILA	FACILITY NUMBER: 274415981
	VISIT DATE: 02/05/2021

NARRATIVE

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Report dated 2/05/21 continues from page 1.

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 the staff records on 2/05/21 indicates that all adults residing in the home have received criminal record and child abuse index clearances or exemptions and are still associated to applicant’s previous license #274414105
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 children 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 months period.
Applicant stated she uses communication with children and redirection as forms of discipline. 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 assistants or substitutes were also discussed. LPA informed applicant that fire/disaster drills must be practiced at least once every 6 months and documented. Applicant states that she is not currently offering transportation to children via vehicle and she understands that children cannot be left in parked vehicles unattended at any time. LPA observed proof of immunization for measles, pertussis and opt out statement for influenza are in file for applicant. Incidental Medical Services (IMS) policy was discussed with applicant. Applicant has completed the "mandated reporter" training AB1207 on 12/11/2019 and applicant understands the training shall be renewed every two years. LPA referred the Applicant to the training website www.mandatedreporterca.com for additional information.
LPA advised applicant of the new regulations on safe sleep for infant children. LPA referred the applicant to the Department website: www.ccld.ca.gov

LPA conducted an exit interview with the applicant in Spanish and informed to her that an small FCCH license will be approved pending on the following: 1) Criminal records clearances or exemptions associated to the applicant previous license would be transferred to this new number, and 2) Approval from a manager of the Licensing Department.

****This report has been emailed to applicant and applicant will reply the email in lieu of a signature.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2021

LIC809 (FAS) - (06/04)

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