384004275-5-12-2020-05-CC-LGOZ-BPK2JY-20200512172708

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004275
Report Date: 05/12/2020
Date Signed: 05/12/2020 05:27:13 PM

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:	RAMOS, ERICA		FACILITY NUMBER:	384004275
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	05/12/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Licensee, Erica Ramos		TIME COMPLETED:	12:30 PM

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THE FOLLOWING INSPECTION WAS CONDUCTED VIA TELE-INSPECTION DUE TO THE COVID-19 SHELTER-IN-PLACE ORDER.

On 5/12/2020 at 11:35 A.M., Licensing Program Analyst (LPA), Luis J. Gomez met with licensee, Erica Ramos, for a scheduled change of location inspection at the new facility. Licensee’s previous license #384002771. Purpose of the inspection was explained. Present is the licensee, licensee’s husband and son; Licensee’s son is preschool age. Applicant rents the home, which is a three bedroom and one and one- half bathroom, one- story house. Current lease agreement in the applicant's name, has not been submitted to licensing. Days and Hours of operations are: Monday – Friday, 8:00 A.M., to 5:00 P.M. Day-care Areas: Dining Room, Bedroom #2, Living Room (Playroom), Bathroom #1 and Patio Area. Off-limit Area: Kitchen, Half bathroom, Bedroom #1, Garage (detached) and Bedroom #3 (Loft). LPA inspected home with licensee for health and safety hazards.

At 11:40 A.M., LPA observed the following. Day-care area is clean, orderly and a variety of age appropriate toys, books and games for the children. All children playthings and accessible furniture are in good repair. Applicant has installed child safety gates, blocking the staircases and off-limit areas. Licensee has child size tables and chairs for snack and activities. For nap time, licensee has several children’s cots stored in the playroom. Bathroom #1, located next to the playroom, is maintained clean with adequate supplies. Licensee has installed child safety locks on accessible cabinets in the kitchen. At 11:50 A.M., LPA observed adult clothing and items in bedroom #2, next to the baby cribs. LPA observed all electrical outlets and trash cans are properly covered. Playrooms has a carpet area for added safety.

(Continuation on page 809-C)

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2020

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

FACILITY NAME: RAMOS, ERICA	FACILITY NUMBER: 384004275
	VISIT DATE: 05/12/2020

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At 12:01 P.M., LPA inspected the facility's patio area. LPA observed licensee outdoor toys and playhouse are in good repair. Patio in completely enclosed with a seating area for the children. At 12:05 P.M., LPA observed an exposed utility gauge and wall piping in the patio area.

LPA observed the home has proper lighting and ventilation throughout. Toxins, detergents and cleaning supplies are stored in an off-limit area, under the kitchen sink. Home does not have a fireplace. There are no pools, jacuzzis, fish pods or other bodies of water. Per licensee, there are no guns or weapons in the home. Per licensee, she will provide all daily snacks and meals for children in care. Home has a functioning cell phone, smoke/ carbon monoxide detector combo and two fully charged fire extinguisher (2A:10BC), located in the playroom and dining room. Licensee has a two pets in the facility ( Dog and Cat).

During inspection, Incidental Medical Services (IMS) was discussed. Licensee's CPR/ 1st aid certification is current expiring: 2/1/2022. Licensee's Mandated Reporter Training is current 11/13/2021. All posting are properly posted in the dinning room, next to the front door. Licensee was reminded that no walkers, excersaucers, jumpers, bouncers and any similar items are allowed in a family child care home. All adults, helpers or assistants must be fingerprinted and associated prior to having contact with children in care. Failure to do so could result in an immediate civil penalty of 100.00 each day. PIN 20-06 CCP was provided and discussed with the licensee.

Prior to change of location approval, licensee must complete the following:

-Submit a current rental agreement in the licensee's name to licensing

-Submit revised Facility Sketch (LIC 999) showing Bedroom #3 (Loft) to licensing

-Move all hazardous items in bedroom #2 to an off-limit area

-Make all wall piping and gauges in the patio area, inaccessible to day-care children

Copy of the report was reviewed and provided to the licensee. This report will be kept in the facility file and made available for public review upon request. Desk Duty is available Monday through Friday between 8AM - 5PM at (650) 266 -8800.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2020

LIC809 (FAS) - (06/04)

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