274415981-2-23-2022-07-CC-FCJO-CBWSY3-20220223131652

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274415981
Report Date: 02/23/2022
Date Signed: 02/23/2022 01:17:00 PM

Document Has Been Signed on 02/23/2022 01:17 PM - It Cannot Be Edited

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: 6	DATE:	02/23/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Zoila Bonilla		TIME COMPLETED:	01:30 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 Analysts (LPA) Fermin Campos-Jaramillo conducted an unannounced annual and change of capacity inspection to the home today. LPA met with Zoila Bonilla, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Friday from 7:30 AM to 5:30 PM. The adults that reside in the home are the licensee and her adult daughter Estrella. There were six children in care during today's inspection. Also in the home reside licensee's minor children ages 17 and 13 years old. Certification for CPR and First Aid Card for Licensee and her helper Estrella are current and will expire on 10/10/22. LPA toured the indoor and outdoor areas of the home during today's inspection. LPA obtained a copy of the children's roster today and it is current. LPA observed that Licensee has conducted a fire drill during the last six months. Last fire drill was documented on 12/06/21. LPA reviewed nine children files and are complete including the parent's rights form and the immunization records form. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas inside are: 3 bedrooms, one bathroom, and the laundry/storage area. Off limits areas outside: A small section of the back yard where licensee has a storage shed. The home has a back yard and it is fenced. LPA observed a fully charged 3A40BC fire extinguisher last time serviced on 2/08/22, and at least one working smoke detector. LPA observed the home has a carbon monoxide detector. LPA observed there are not stairs or bodies of water in the home. LPA observed there is a fish tank in the on limits area, and it has a lid that totally covers the top of it, and it is unreachable by the children in care. LPA observed the tank seats on top of a wood chest. LPA observed the home has in the on limits area an electric fireplace barricaded with a glass screen. Licensee stated she turns it on only on cold days before the children arrive. LPA observed the home has a wall heater which has been barricaded with wood. Licensee stated the wall heater has been disabled previously to provide childcare. Licensee stated they do not have pets in the home. Licensee states that there are not weapons in the home. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. Report dated 2/23/22 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: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

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: 02/23/2022

NARRATIVE

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Report dated 2/23/22 continues from page 1.

LPA discussed Incidental Medical Services with licensee. According with the SB792, Licensee has presented proof that she has immunization for herself and for her helpers for measles, pertussis and influenza.
Supervision of children was discussed with Licensee and she understands that she or qualified helpers must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands the capacity options and she understands that, if eventually a large license is granted, she cannot have more than 14 children in the home at any time and a helper must be present. Licensee understands in absence of a helper her license is reduced in capacity and ratio (age of the children) to a small Family Child Care Home license (maximum 8). Licensee states that she does not transport children via vehicle and that she understands that children cannot be left in parked vehicles unattended at any time.
Department website: www.ccld.ca.gov provided to Licensee.
LPA discussed the requirements of AB 633 whenever a Type A deficiency is cited. LPA also discussed "zero tolerance" related regulations with the Licensee.
LPA observed that Licensee and her helper have renewed the "Mandated Reporter" training on 1/05/22 and her helper on 2/07/21. Licensee understands the training must be renewed every two years. LPA referred the Licensee to the Department website: www.mandatedreporterca.com for additional information on the online training.
A review of staff records on 2/15/22 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee Zoila Bonilla was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Report dated 2/23/22 continues on page 3.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

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: 02/23/2022

NARRATIVE

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Report dated 2/23/22 continuers from page 2.

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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

LPA noticed that a Fire Clearance has been granted to this address by the Seaside Fire Department on 2/10/22.

Exit interview conducted and report was reviewed with the licensee Zoila Bonilla.

No deficiencies were cited today.

A notice of site visit was given and must remain posted for 30 days.

LPA conducted an exit interview with the licensee and advised her that a large FCCH license will be approved pending on the following: 1) 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: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

LIC809 (FAS) - (06/04)

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