384000854-12-20-2022-05-CC-LTMO-CMASYV-20221220131811

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000854
Report Date: 12/20/2022
Date Signed: 12/20/2022 01:25:46 PM

Document Has Been Signed on 12/20/2022 01:25 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SUAREZ, DELIA MARGARITA		FACILITY NUMBER:	384000854
ADMINISTRATOR:	SUAREZ, DELIA MARGARITA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 516-3272
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94124
CAPACITY:	14	CENSUS: 6	DATE:	12/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Assistant, Veronica Ramirez		TIME COMPLETED:	01:45 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	On December 20th, 2022 at approximately 10am, Licensing Program Analysts (LPAs) Tapia-Mandujano and Olguin-Leon conducted an unannounced Annual Required inspection. LPAs met with Assistant, Veronica Ramirez and explained purpose of inspection. Per assistant, licensee, Delia Suarez is out on vacation. Present in the home were two two adult staff caring for 6 enrolled children (one infant, four preschool age, and one school age child). Licensee owns home and lives with her 3 other adult resident. Home is a 5 bedroom, 2 bathroom, two level house. The Hours of operation are Monday-Friday from 7:30am-5pm. Facility was inspected and the Daycare areas are: Street level: Dining area, Bedroom #1, Bathroom #1, Backyard, and Backhouse in the Backyard. Off limit areas are: Entire Lower Level: Bedroom #3, #4, #5, Bathroom #2, and Laundry Room. Street Level: Living Room/Office, Bedroom#2, Kitchen (eating only), and Garage. All off limit areas, including closets, are properly barricaded. LPAs toured day care areas of home with assistant. LPAs observed home to be clean and in good repair with proper temperature and ventilation. There were a variety of age appropriate toys and equipment in the home which were in good condition. There were no pools, spas or bodies of water on the property. All cleaning supplies, poisons and other chemicals were stored inaccessible to children. Important postings were posted on the hallway. There was a fully charged fire extinguisher, smoke alarm and carbon monoxide alarm, and a working telephone on site. Phone number listed is current. Per Assistant, there are no weapons or firearms in the home. LPAs reviewed 6 children’s records. LPA also reviewed facility records and assistant records. Assistant's CPR & First Aid Certificate expires on 11/2024. Assistant's Mandated reporter certificate expires 04/2024. Last emergency drill was conducted 08/2022. Emergency drills are conducted at least once every six months but were properly logged. Continued on Page 2...

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

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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Document Has Been Signed on 12/20/2022 01:25 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SUAREZ, DELIA MARGARITA	FACILITY NUMBER: 384000854
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/20/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102370(d)

Criminal Record Clearance

(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above in as there is an uncleared adult present in the home, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 12/21/2022
	Plan of Correction
1 2 3 4	Facility will have uncleared adult resolve fingerpirnt clearance. Facility will not allow uncleared adult to be present in the facility until fingerprints are cleared.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SUAREZ, DELIA MARGARITA	FACILITY NUMBER: 384000854
	VISIT DATE: 12/20/2022

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. Licensee does offer IMS at this time. 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: 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/inspection-process.

Licensee/Assistant 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 webpage 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.

At approximately 10:30am, LPAs observed that one adult staff did not have fingerprint clearance on file.

*See following page for deficiencies cited against the facility today under CCR,Title 22, Div. 12, Chapt. 1*

Type “A” violations were issued today. Licensees were advised to provide a copy of the Evaluation Report and all Type “A” Deficiencies cited, to the parents and guardians of children currently enrolled in care and to parents of newly enrolled children during the next 12 months. A signed and dated LIC 9224 shall be maintained in all Children's files.

A notice of site visit will be emailed and must remain posted for 30 days.

An exit interview conducted and report was reviewed with the Assistant, Veronica Ramirez. .

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

LIC809 (FAS) - (06/04)

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