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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274416097
Report Date: 12/17/2021
Date Signed: 12/20/2021 08:33:17 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:ALVAREZ-GONZALEZ, PATRICIAFACILITY NUMBER:
274416097
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
12/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Patricia Alvarez-Gonzalez TIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Elizabeth Larios met with Patricia Alvarez-Gonzalez, Licensee, for unannounced Required – 1 year annual inspection. LPA was granted access to the home by the Licensee. Licensee currently does not have any children in care. LPA observed the required postings, including the facility license, near the front entrance to the home. Days and hours of operation are Monday - Friday from 6:00 AM to 6:00 PM. Licensee and her husband Luis Munoz are the only adults residing in the home.

LPA reviewed a current Child Care Facility Roster during today's inspection, which lists children that were enrolled in March until present. Licensee has liability insurance for the day care through DCI insurance. Licensee has current CPR and First Aid certifications (expiration: 10/19/2022). Licensee has the required vaccines (MMR, Tdap, & flu opt out) and is current with the Mandated Reporter Training for Child Care Workers (expiration: 01/15/2022). LPA reviewed one staff files (Licensee) and the file was complete with the required forms.
LPA discussed the safe sleep regulations with the Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone. LPA observed sufficient materials, toys, and play equipment for the day care children. Licensee states that a child will be isolated in living home of the home if necessary due to illness or communicable disease.

SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth LariosTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
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: ALVAREZ-GONZALEZ, PATRICIA
FACILITY NUMBER: 274416097
VISIT DATE: 12/17/2021
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The home is clean and orderly, with central heating/air conditioning for safety & comfort. LPA observed a barricaded fireplace, as well as three gated wall heaters. Off limit areas in the home: all bedrooms, and garage. There are no stairs inside the home. Off limit areas outside the home: far right side of the back yard remains off limits. The portion of the yard that is off limits is home to one of the two dogs that Licensee has in home. Per Licensee the another dog is kept inside the home.

LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. Licensee states that she has two dogs that are fully vaccinated and no weapons in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. All poisons are locked in the attached off limits garage. Licensee states that she does not administer any medication to the day care children.

Licensee 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.

Supervision of children was discussed with Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity options and she understands that she cannot have more than 8 children in the home at any time without at least one qualified adults present. Licensee states that she does not transport any day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.


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

Exit interview conducted and report was reviewed with the Licensee, Patricia Alvarez-Gonzalez. No deficiencies issued during today's inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Elizabeth LariosTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
LIC809 (FAS) - (06/04)
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