304313593-7-27-2020-06-CC-KDEI-BRWQJS-20200727121312

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313593
Report Date: 07/27/2020
Date Signed: 07/27/2020 12:13:29 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	MALDONADO, SOCORRO		FACILITY NUMBER:	304313593
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	07/27/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Licensee Maldonado Socorro		TIME COMPLETED:	11:15 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) Ketki Desai conducted a Case Management – Licensee initiated (Capacity increase) inspection today. LPA met with License Maldonado Socorro via Google Duo Face time and guided analyst on a tour of the facility. The inspection is being conducted via Face time due to pandemic situation and it was pre-scheduled inspection. Per Licensee, family members residing in the home are 2 adults and one minor child. Adults residing in the home have obtained their background checks. The Licensee is requesting a Large family childcare home license. Per Licensee, operating hours will be Monday to Friday, 7:00AM to 5:00PM. Licensee states that she will care for children ages Newborn to 14 years of age. During today’s inspection there were 3 children (2 infants and one preschool age child) including Licensee’s daughter Cynthia Maldonado who is also the assistant providing care and supervision has met the requirements of an assistant. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single, -story home that consists of 4 bedrooms, 3 restrooms, 2 living rooms, extension den area, kitchen, backyard and garage. There is no stairway or fireplace in the home. Per Licensee, the children will use the following one living room converted into a playroom / extension den area converted into napping room, one bathroom and backyard. Restroom located in the napping room area. Living area (Playroom) has age appropriate activities and educational materials for children. The Napping area shall be used also an isolation area. (page 1)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2020

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MALDONADO, SOCORRO	FACILITY NUMBER: 304313593
	VISIT DATE: 07/27/2020

NARRATIVE

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Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating. The home has a center air and heat. There is locked door leading to the kitchen area which remains inaccessible to children. However, children walk through the kitchen to access the back yard for outdoor activities. Kitchen cabinets are locked with child safety locked and during operating hours the door leading into the kitchen area remains closed and locked.

Based on the Facility Sketch submitted, areas off limits to children and parents are: (four bedrooms and two bathrooms) Kitchen, garage. Kitchen cabinets have child safety locks and all sharp objects are stored in a locked cabinet. Licensee states that the doors shall be closed during the hours of operation.

OUTDOOR PLAY AREA: Back yard is fenced from all the sides, it also has a shaded patio area and grassy area where outdoor toys along with a covered playhouse, there is one climbing structure placed on artificial grass turf. There were no hazardous observed.

Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The Licensee states (that there are no poisons on the premises).

Per Licensee there are no firearms, weapons or bodies of water on the premises.

The value on the 2A10BC fire extinguisher indicates fully charged, as indicated on service tag observed. Smoke and carbon monoxide detectors were tested and are operable.

There are toys available for children. mats are used during napping time, linens and blankets are provided by the parents. Young infants nap in the play pens/ cribs. There is also a changing station for young infants and toddlers.

The Licensee provides food for children in care. If food is not provided and food is brought from the children’s homes; container shall be labeled with child’s name and properly stored or refrigerated.

The Licensee t has completed the required Health and Safety with Nutrition and Lead Poisoning component Training and Pediatric First Aid and CPR which expires 5/4/2021. There are first aid supplies available.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2020

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MALDONADO, SOCORRO	FACILITY NUMBER: 304313593
	VISIT DATE: 07/27/2020

NARRATIVE

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The following items were also discussed with licensee during this inspection.

All homes shall conduct fire and disaster drills at least once every six months and document the drills.

PETS: There is one pet dog on the premises.

POSTING REQUIREMENTS: Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted.

PROHIBITED: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family childcare facility.

SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME.

UPDATE: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and one adult working with children have proof of immunization.

UPDATE: Health and Safety Code 1596.7995: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

Incidental Medical Services (IMS): As per Licensee, currently there are no enrolled children receiving these services.
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 (Page -3)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2020

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MALDONADO, SOCORRO	FACILITY NUMBER: 304313593
	VISIT DATE: 07/27/2020

NARRATIVE

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LPA advised the licensee how to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.
LPA consulted and explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices.

Capacity Handout (Small & Large) was provided via email to the licensee

Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report). Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients.

Currently, the licensee is in compliance with California Code of Regulations Title 22 for operating a Family Child Care home.

A new license for operating a Large Family Child Care Home shall be issued upon approval.

The report is being emailed to the Licensee, due to Covid 19 pandemic and LPA has requested a written acknowledgement of the report being read.

Appeal Rights were also emailed to the Licensee.

No deficiency cited during today's tele-inspection

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2020

LIC809 (FAS) - (06/04)

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