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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000845
Report Date: 10/09/2019
Date Signed: 10/09/2019 04:37:05 PM

COMPREHENSIVE INSPECTION
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:GONZALES, REGINA LOUISEFACILITY NUMBER:
414000845
ADMINISTRATOR:GONZALES, REGINA LOUISEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 366-1773
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY:14CENSUS: 9DATE:
10/09/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Regina L Gonzales & Katherine BraccoTIME COMPLETED:
04:35 PM
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Licensing Program Analyst (LPA) Singh met with licensee, Regina L. Gonzales, for an annual random inspection. The purpose of the inspection was explained. Licensee lives in a single family home. Present, there are nine children (four infants, five pre school age) in care with licensee and one helper. All adults living or working in the home have criminal background check on file. Licensee is operating within the capacity of this date. Licensee provides day care from Monday to Friday between 8 AM to 5 PM.

LPA inspected the day care areas with the licensee. Day Care Areas: Garage, Bathroom in the garage and Backyard. Off limit areas: Rest of the house including the entire second floor. There is no pool, spa or any other body of water in the house. As per licensee, there is no firearm or weapon in the house. All the cleaning supplies, poisons and other chemicals are stored in the closet. The closet has child protective lock installed and is inaccessible to the children. There is no fireplace in the day care area. Stairs has gate installed. The house is in good repair and free of hazards with proper temperature and ventilation. There is carbon monoxide detector, smoke detector, fully charged fire extinguisher and working telephone available in the house. There is a variety of age appropriate toys in the house.

At 3 PM, LPA review the children's record. LPA reviewed the identification and emergency information form for every child for proper names and numbers filled. LPA observed the signed copies of medical consent in facility records. Licensee has record of training of preventive health and CPR card valid until November 2019. Licensee stated that she has signed up for the upcoming class to renew the CPR. LPA observed licensee has a log for fire and emergency drills. Per log, last drill was conducted in August 28, 2019. LPA observed licensee has all of the required documents posted and are visible for public. Licensee’s and helper’s record of immunization was checked during previous inspection. LPA observed the completion certificate for the Mandated reporter training. Per certificate, the training was completed on January 12, 2019. The training can be obtained online at www.mandatedreporterca.com. See next page for continuation .................
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: GONZALES, REGINA LOUISE
FACILITY NUMBER: 414000845
VISIT DATE: 10/09/2019
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Continuation from previous page ..........

LPA discussed the safe sleep regulation concepts and a handout was provided. LPA also discussed the effects of lead exposure and provided a handout. LPA encourage the licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
LIC809 (FAS) - (06/04)
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