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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001261
Report Date: 03/24/2022
Date Signed: 03/24/2022 06:02:50 PM


Document Has Been Signed on 03/24/2022 06:02 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:OLIVARES, MAGDA O.FACILITY NUMBER:
414001261
ADMINISTRATOR:OLIVARES, MAGDA O.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 207-5083
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY:14CENSUS: 11DATE:
03/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Magda OlivaresTIME COMPLETED:
02:50 PM
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On March 24th, 2022 at 12:20pm, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced required annual inspection. Purpose of the inspection was explained. LPA met with licensee, Magda Olivares. Present in the facility are licensee and three assistants caring for 11 children (2 infants and 9 preschoolers). Licensee is operating within capacity limits. All adults living and working in the home have a criminal record clearance on file.

Licensee asked to add Bedroom #1 for Daycare use. LPA observed room to be clean and safe for children. LPA has approved Bedroom #1 for Daycare use.

Licensee owns home and lives with Husband. Home is a single level house with 3 bedrooms, 2 Bathrooms, and a detached Garage. The hours of operation are Monday-Friday from 7:30am-5:30pm. Daycare areas are: Living Room, Bathroom #1, Bedroom #1, Bedroom #2, Bedroom #3, Dining/Play area, Front porch, and portion of the backyard. Off Limit areas are: Bathroom #2 (inside Bedroom #3), Laundry room, converted (detached) Garage and Storage unit in the backyard, portion of the Backyard, and driveway area. All off limit areas, including closets, are maintained properly barricaded.

LPA toured day care areas of home with Licensee. LPA 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. Home has a fireplace that is properly barricaded. There were no pools, spas or bodies of water on the property. All cleaning supplies, poisons and other chemicals were stored inaccessible to children. Discipline Policy was discussed.

There was a fully charged fire extinguisher, smoke alarm and carbon monoxide alarm, and a working telephone on site. Phone number listed for Licensee is current. Per Licensee, there are no weapons or firearms in the home. LPA reviewed children’s records which were complete. LPA also reviewed facility and employee records. Licensees CPR & First Aid Certificate expires on 6/2023. Licensee's Mandated Reporter Training will expire 11/23. Last emergency drill was conducted 2/17/22. Emergency drills are conducted at least once every six months and are properly logged.

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SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
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 5


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: OLIVARES, MAGDA O.
FACILITY NUMBER: 414001261
VISIT DATE: 03/24/2022
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Incidental Medical Services (IMS) policy was discussed. Licensee does offer IMS. 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/process.

Licensee 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Magda Olivares.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022
LIC809 (FAS) - (06/04)
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