344500085-7-1-2020-53-CC-ESIA-BR52QZ-20200701173645

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 344500085
Report Date: 07/01/2020
Date Signed: 07/01/2020 05:36:54 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	MENDOZA, ALMA		FACILITY NUMBER:	344500085
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	07/01/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Alma Mendoza		TIME COMPLETED:	10:45 AM

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On Wednesday, July 1, 2020 at approximately 08:30 AM Licensing Program Analyst (LPA) Elvira Sierra contacted Licensee Alma Mendoza for the purpose of an announced pre-licensing/increase of capacity tele-inspection. Licensee had recently submitted an application for an increase in capacity from 8 to 14 children. Due to COVID-19 pandemic LPA is conducting the meeting via Google Duo. Licensee operate 7 days a week 24 hours a day. Licensee understand that care cannot exceed more than 24 hours. Present during the tele-inspection was Licensee, her husband, daughter and granddaughter.

A health and safety inspection was conducted inside and out. This facility is a one single story home which consists of 5 bedrooms, 2 bathrooms, living room, kitchen, dining room, laundry room, backyard, front yard and garage. The off-limit areas in the home will consist of; All bedrooms, bathroom # 2 (inside master bedroom), laundry room, front yard, driveway and garage. Fire extinguisher, smoke and carbon monoxide detectors meet regulation. Sharp knives are stored in a kitchen cabinet above the counter. Toxins and cleaning supplies are inaccessible to the children in the laundry room. Toys appear to be safe and appropriate for children in care. Licensee stated that there are no weapons in the home and no bodies of water. The facility currently does not provide Incidental Medical Services – IMS. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family childcare home evaluator manual (FCCH EM) Policy 102417.

Adult residents and assistants have criminal record clearance. No additional adults have moved into the home since licensure. A current CPR/First Aid was verified and expired on 09/21. LPA reviewed large family childcare home capacity limitations with licensees. LPA discussed SB 277 and SB 792 pertaining to immunization requirement for children and staff and advised Licensee to visit the licensing website at www.ccld.ca.gov for current forms, laws, regulations and legislation.

Report continued on subsequent page 809C----

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2020

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MENDOZA, ALMA	FACILITY NUMBER: 344500085
	VISIT DATE: 07/01/2020

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The Department received Fire Safety Inspection Clearance on 06/29/20 and home has been cleared for up to 14 children.

LPA provided to Licensee via email transmission the Safe Sleep in Child Care and the Effects of Lead Exposure brochures. LPA also emailed COVID-19 Posting documents, Use of Personal Protective Equipment during COVID-19 Outbreak guidance, COVID-19 Self-Assessment Guide, and PIN #20-06 guidance and practice regarding social and physical distance to prevent exposure to COVID-19.

As of today's date, facility is licensed to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or elementary school and 1 child at least age 6 with a maximum of 3 infants.

In lieu of Licensee's signature, LPA is e-mailing the report with a read receipt request to Licensee. Notice of Site Visit was email to Licensee. Notice of Site Visit should be posted in a conspicuous area for 30 days.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2020

LIC809 (FAS) - (06/04)

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