384004275-6-30-2020-05-CC-LGOZ-BR3UQX-20200630154751

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004275
Report Date: 06/30/2020
Date Signed: 06/30/2020 03:48:36 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: 4	DATE:	06/30/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Licensee, Erica Ramos		TIME COMPLETED:	02:00 PM

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

On 6/30/2020 at 1:32P.M., Licensing Program Analyst (LPA), Luis J. Gomez met with licensee, Erica Ramos. The purpose of the inspection was explained and is for a Case Management inspection for an Increase in Capacity. Present is the licensee and licensee’s husband caring for four children; three preschool age and one infant age. Licensee is within the required capacity limits of the license on this day. All adults in the home have proper criminal record clearances on file. Day-care Areas are: Dining Room, Bedroom #2, Living Room (Playroom), Bathroom #1 and the Covered Patio Area. Off-limit Areas are: Kitchen, Half Bathroom, Bedroom #1, Garage (detached) and Bedroom #3 (Upstairs Loft). LPA inspection the day-care with the licensee for health and safety hazards.

At 1:35P.M., LPA observed the following: Day-care area is clean, orderly with plenty of age appropriate toys and games for the children. All furniture and playthings inspected are in good repair. There are several child size tables and chairs available for snack and activities. All off-limit area, including staircase leading upstairs are properly barricaded with child safety gates. Bedroom #2, located in the hallway, is free of hazards or dangerous conditions. Bathroom #2 located in the playroom, is maintain clean with adequate supplies for the children. Accessible cabinets have child safe locks installed.

At 1:42P.M.,LPA observed the patio area in completely enclosed. Licensee has installed additional wooden safety boxes along the patio wall. Licensee stated children will bring refillable water bottles during outside play. The home does not have a swimming pool, spa, hot tub, fishpond or any other bodies of water. Toxins, detergents and cleaning supplies are stored in an off-limit area.

Continuation on 809-C

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2020

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: 06/30/2020

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Outlets and trash cans are properly covered. Day-care has a functioning home phone, smoke /carbon monoxide detector combos, and two fully charged fire extinguisher (2A:10BC), located in the dining room and playroom. Licensee has installed a fire pull alarm in the facility dining room and playroom.

The capacity limits for a large license has been reviewed with the licensee. Licensee was reminded that when operating at a large capacity, there must be a helper present.

On 4/21/2020, LIC 9149 was signed by both the landlord and licensee.

On 6/29/2020, Fire Clearance Request was granted with no restrictions.

On 6/30/2020, licensee will be recommendation for a Large Capacity

This report must be available in the facility for public review. Notice of site visit was observed being posted. Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2020

LIC809 (FAS) - (06/04)

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