430756857-10-6-2021-52-CC-MESA-C7JT2W-20211006142125

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430756857
Report Date: 10/06/2021
Date Signed: 10/06/2021 02:38:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	RAMOS, VIVIANA & MARIO		FACILITY NUMBER:	430756857
ADMINISTRATOR:	RAMOS, VIVIANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 934-1463
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	14	CENSUS: 1	DATE:	10/06/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Mario and Viviana Ramos		TIME COMPLETED:	02:40 PM

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On Wednesday, October 6, 2021 1:15 PM, Licensing Program Analyst (LPA) Manel Estoesta conducted an Unannounced Required 1 Year Visit. LPA met with the licensee's Mario and Viviana Ramos and explained the nature of site visit. Present for this visit were three (3) licensee's grandchildren over 11 years old and one (1) preschool child. The facility currently operates from Monday to Friday 7:30 AM to 6 PM.

The home was toured to conduct a Health and Safety Inspection. The home is a one story home. The home is neat and clean with heating and ventilation for safety and comfort. The ON LIMIT AREAS (accessible to children in care) are the living room, kitchen, hallway bathroom and the front yard. The front yard play area is completely fenced. The OFF-LIMIT AREAS the whole backyard where the swimming pool is located and fenced, all four bedrooms, the garage, and the room adjacent to the front door which will be inaccessible to children in care by closed and or locked doors and or a fence with visual supervision. There are ample age appropriate toys that appear to be safe and in good condition. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible today. Facility’s License, Emergency Disaster Plan, and Notification of Parents’ Rights were observed to be posted and LPA discussed with Licensee about the personal rights of children in care.

At 1:30 PM, LPA observed 3 unleashed pet dogs in the front yard and the licensee's grand daughter playing. At 1:45, LPA observed a pet bird inside it's cage in the living room next to the sliding door to the pool.

The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector and working telephone. The fireplace is being blocked by a furniture to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills.

SEE 809 C.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: RAMOS, VIVIANA & MARIO	FACILITY NUMBER: 430756857
	VISIT DATE: 10/06/2021

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Continuation....

Licensee owns the house and does not carry childcare liability insurance. The licensee CPR and First Aid certificate and expires on 12/05/2021. The Licensee stated that they completed AB1207. Licensees have records of Measles and Pertussis immunization, Influenza vaccination and TB clearance. LPA reminded Licensee that only the Influenza vaccination can be decline with a written declination. Children’s files were reviewed, which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, and Immunization. The licensee is in ratio today.

Individual Medical Services (IMS) policy was discussed. 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: https://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/inspection-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 [facility representative] 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.

There are no deficiencies cited on this visit.

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

Exit interview conducted and report was reviewed with the licensee's Mario and Viviana Ramos.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

LIC809 (FAS) - (06/04)

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