274416431-12-8-2020-07-CC-DMAC-BW4VGJ-20201208152538

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274416431
Report Date: 12/01/2020
Date Signed: 12/08/2020 03:25:44 PM

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:	RIVERA, YANIRA		FACILITY NUMBER:	274416431
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	12/01/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Yanira Rivera		TIME COMPLETED:	10:40 AM

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) Dung Mac conducted an announced case-management tele-inspection via video conference call (FaceTime) with Yanira Rivera, Licensee. Licensee submitted the application to the Department on July 20, 2020. A fire safety inspection request approval was received from City of Salinas Fire Department on November 20, 2020. Days and hours of operation are Monday to Friday from 6:00AM to 6:00PM. LPA observed five daycare children (one preschool and four school-age) and Licensee's minor son in the home during today's tele-inspection. The adults that reside in the home: Licensee, Licensee’s spouse (Daniel Garcia-Esparza), and sister-in-law (Vannesa Rojas-Esparza). All individuals subject to a criminal record review have obtained a criminal record and child abuse index clearances prior to today's tele-inspection. Licensee’s First Aid and CPR certificates are current and expire on 3/07/2022. Copies of immunization records and a proof of completion of Mandated Reporter Training (completed on 6/17/2019) are on file. LPA reminded Licensee that the Mandated Reporter Training requires renewal every two years. Licensee owns the home and a copy of Control of Property is on file. Licensee has liability insurance and understands that if liability insurance is not carried, she will have the parents complete the Affidavit Regarding Liability Insurance (LIC 9182). Licensee states that she does not transport children at this time, but she understands that children cannot be left in parked vehicles unattended at any time. Licensee agreed to give LPA a tour of the home (indoor/outdoor) via FaceTime during today's tele-inspection.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2020

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: RIVERA, YANIRA	FACILITY NUMBER: 274416431
	VISIT DATE: 12/01/2020

NARRATIVE

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The home is clean and orderly. There are no stairs inside the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The off-limit areas inside the home are as follows: master bedroom, master bathroom, bedroom 2, bedroom 3, laundry, and garage. Licensee has a designated area in the home where a child(ren) can be isolated if exhibiting signs of illness.

Licensee states that the home does not have fireplace and any wall heaters. LPA observed a fully charged 3A40BC fire extinguisher. LPA observed the home has working smoke/carbon monoxide detectors (tested by the Licensee during today's tele-inspection). Licensee states that there are firearms in the home. LPA observed a securely locked gun safe, and ammunition is stored separately. Licensee has a first aid kit in the home, which also has a thermometer and sufficient emergency supplies.

LPA observed that detergents, cleaning products, medications, hazardous, sharp objects, and similar items that are dangerous to children in care were stored inaccessible, out of reach of children. LPA reminded Licensee that all poisons must be locked up with a key or a combination of keys. The home has one medium-sized dog. Per Licensee, the dog is up-to-date with vaccination and is kept away during daycare hours.

LPA informed Licensee that smoking is prohibited in the home during daycare hours. Licensee understands and states that nobody smokes in the home. Licensee states that she does not have any baby walkers/inclined sleepers in the home and understands that baby walkers/inclined sleepers are not allowed in the home. Licensee states that she does not have any baby bouncers, jumpers, saucer chairs, and trampoline in the home.

The refrigerator and freezer in the home is clean. There are no sharp utensils, lighter/matches, or open bottles of alcohol accessible to children. All cabinets and drawers in the kitchen are inaccessible to children. Licensee understands that any food/drink which is brought by parent(s) of day care child(ren) must be properly labeled with the child(ren) name and properly stored or refrigerated.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2020

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: RIVERA, YANIRA	FACILITY NUMBER: 274416431
	VISIT DATE: 12/01/2020

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The bathroom toilets and faucets are clean and operable. The bathtub and shower are free of any hazards. All shampoos, soap, medication, mouthwash, perfumes, razors, cleaning products, air fresheners, and nail polish/remover are inaccessible to the children.

Off limit areas outside the home: left side of the yard. LPA observed the off-limit area has a locked gate. The backyard is adequately fenced and is used for outdoor activity space. LPA reminded Licensee that children must be supervised at all times while outdoors. There are no bodies of water. LPA did not observe any storages/sheds and play structures in the backyard.

LPA reminded Licensee 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. For an initial violation, civil penalty amounts to $100.00 per person per day, up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day, up to $3000.00 per person.

Incidental Medical Services (IMS) policy was discussed. Licensee states that she does not have children who requires IMS at this time. Licensee was provided the information regarding ADA: toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: http://www.ada.gov/childqanda.htm.

A Family Child Care Home packet with updated Licensing forms, “Lead Poisoning Facts Information" Flyer, and "Safe Sleep" Information were mailed to the Licensee prior to today's tele-inspection and Licensee acknowledged receipt of the packet.

Licensee was informed that due to the current Covid-19 pandemic and "Shelter In Place" Order, the Facility Evaluation Report will be emailed to Licensee (email: yayasfcc@gmail.com) with "Read Receipt" notification. Licensee understands that her reply to the email will serve as acknowledgement that the report was received.

LPA conducted an exit interview and advised Licensee that a large Family Child Care Home license will be approved upon receiving of Acknowledgement of "receipt" of today's report.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Dung Mac	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2020

LIC809 (FAS) - (06/04)

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