414002719-10-11-2022-05-CC-CQUO-CK4P7C-20221011110340

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002719
Report Date: 10/11/2022
Date Signed: 10/11/2022 11:04:20 AM

Document Has Been Signed on 10/11/2022 11:04 AM - 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:	AMANTE, MARTA & VILLENA, JOSE		FACILITY NUMBER:	414002719
ADMINISTRATOR:	AMANTE, M. & VILLENA, J.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 477-2745
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	14	CENSUS: 8	DATE:	10/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Marta Amante		TIME COMPLETED:	11:15 AM

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	On October 11, 2022 at approximately 8:20am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Marta Amante, and explained the purpose of the inspection. Present during LPA's visit included both licensees, licensee's assistant (A1), and 8 enrolled children (3 infants and 5 preschool age). Licensees are operating within capacity limits and ratio during LPA's visit. All adults living and working in the home have fingerprint clearance on file. Hours of operation are Monday to Friday from 8:30am to 5:00pm. Licensees live in the home with their two minor children, in a single level, family home. The home consists of 3 bedrooms, 2 bathrooms, living room, kitchen, backyard and garage. The DAY CARE AREAS are the living room, kitchen, bathroom, and backyard. The OFF LIMIT AREAS are all bedrooms,bathroom #2 and garage. All off limit areas are made inaccessible with child safety locked doors. With licensee, LPA inspected day care areas for health and safety hazards. LPA observed home to be in good repair with proper temperature and ventilation. Home operates as a Montessori program. LPA observed home to have a variety of age appropriate, Montessori materials and equipment that were in good condition. Home has a fireplace that is properly barricaded. Electrical outlets are made inaccessible, blocked by furniture. LPA observed cleaning supplies, poisons and other chemicals to be stored inaccessible behind child safety locked cabinets. Home is equipped with multiple carbon monoxide detectors, smoke detectors, and a working phone on site. Phone number listed for licensee is current. Per licensee, there are no weapons or firearms in the home. LPA observed required licensing documents to be properly posted near front door, available for review. Entire backyard is fenced with an at least 5 ft. high fence. LPA did not observe backyard to have any pools, spas or bodies of water on the property. Backyard is equipped with appropriate outdoor toys and equipment that were in good working condition. LPA observed backyard to be cushioned with artificial turf and have sufficient shade. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

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: AMANTE, MARTA & VILLENA, JOSE	FACILITY NUMBER: 414002719
	VISIT DATE: 10/11/2022

NARRATIVE

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LPA reviewed 10 children's records which were complete. Children's files have a record of emergency identification information on file. LPA reviewed licensee and A1's file which were also complete. Both licensee and A1 have a CPR certificate that is current. Licensee's CPR certificate will expire 08/2024. Both licensee and A1's Mandated Reporter training certificates are also current. Licensee and A1 have proof of required immunizations that were made available for LPA's review.

Last emergency drill was conducted 09/02/2022. Emergency drills are conducted at least once every six months and are properly logged. Licensee also maintains safe sleep logs for napping infants. Safe sleep logs are properly documented, with 15 minute time checks of when napping infant was last checked on as well as napping infant's sleeping position.

During Inspection:
-Licensee was given information regarding annual fee payment.
-Licensee was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.
-Licensee was reminded about Mandated Reporter training at www.mandatedreporterca.com. Training must be completed every two years by licensee and all staff hired.

Incidental Medical Services (IMS) policy was discussed. 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
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SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

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: AMANTE, MARTA & VILLENA, JOSE	FACILITY NUMBER: 414002719
	VISIT DATE: 10/11/2022

NARRATIVE

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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.

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Marta Amante.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

LIC809 (FAS) - (06/04)

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