384004316-5-18-2022-05-CC-JYEE-CEJRY3-20220518132541

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004316
Report Date: 05/18/2022
Date Signed: 05/18/2022 01:26:06 PM

Document Has Been Signed on 05/18/2022 01:26 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:	BAQUERO, ANGELA V.		FACILITY NUMBER:	384004316
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	05/18/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Angela V. Baquero		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	Licensing Program Analyst, LPA Yee conducted a case management inspection today. The facility has requested to increase the capacity for a large daycare. LPA met with Angela Baquero. Present at the facility are Angela, her husband, and 5 children (1 infant). LPA inspected the daycare areas with Angela. Current residents are Angela, her husband, Jose's 16 years old son, and their 2 years old daughter. Days and hours of operation: Monday to Friday between 7:30 AM to 6:00 PM. Day Care Areas (lower level): living room, bathroom, room #1, room #2, and backyard. The off-limit area: the entire upper level, and garage. The home is equipped with a carbon monoxide detector, smoke detector, and fire extinguisher that meets the fire department standard are available. LPA advised the to conduct emergency drills once every six months and keep a log sheet. The applicant has required immunization records on file. The 8 hours Health and Safety certificate is on file. CPR and 1st aid are current. Incidental Medical Services (IMS) policy was discussed. This facility plans to provide Incidental Medical Services - IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 102417. 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 LPA review AB 1207 with the Licensee. As of January 1, 2018, all staff members are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. AB 1207 certificate for the licensee is on file. continue next page.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022

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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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: BAQUERO, ANGELA V.	FACILITY NUMBER: 384004316
	VISIT DATE: 05/18/2022

NARRATIVE

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LPA reminded the licensee that she can not have outside employment that interferes with her daycare. She said she understand.

The licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, before 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 the applicant 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 the applicant 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.
LPA reviewed with the applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.
Individual Infant Sleeping Plan (LIC9227) form was provided. Technical support for COVID was discussed. Website for forms and regulations: www.ccld.ca.gov.

LPA reminded Angela that for a large daycare, she would need a helper to help her out. The capacity worksheet was provided and explained.

Fire clearance for a large FCCH is approved and on file.

LPA will recommend a large license for this daycare.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022

LIC809 (FAS) - (06/04)

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