434403424-5-31-2019-07-CC-MSMS-BCPMZW-20190531100350

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434403424
Report Date: 05/31/2019
Date Signed: 05/31/2019 10:03:55 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CERON, LEONOR		FACILITY NUMBER:	434403424
ADMINISTRATOR:	LEONOR CERON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 732-1993
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94085
CAPACITY:	14	CENSUS: 0	DATE:	05/31/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Leonor Ceron		TIME COMPLETED:	10:15 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	Licensing Program Analyst (LPA) Mel Matos met with Leonor Ceron, Licensee, for an unannounced annual/random inspection. Licensee's parents, Licensee's brother, and Licensee's sister were also present in the home during today's inspection. No day care children were present during today's inspection because the day care is closed this week. Days and hours of operation are Monday to Friday from 7:30 AM to 6:00 PM. The adults that reside in the home are the Licensee, Licensee's parents, Licensee's brother, and Licensee's sister. Licensee's certifications for CPR and First Aid are current and expire on September 1, 2020. LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed in December 2018. LPA reviewed twelve children's files (4 infants & 8 preschool) and observed current and updated immunization records and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A) in each file. The Licensee also has record of completion of the Mandated Reporter training for child care workers. LPA toured the indoor and outdoor areas of the home during today's inspection. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is clean, orderly, and safe for the day care children. LPA observed barricaded wall heaters (located between the living room & hallway areas) inside the home. Off limit areas in the home: two bedrooms, kitchen, and barricaded fireplace (located in the living room area). There are no stairs inside the home. Off limit areas outside the home: right side area of the backyard. LPA observed a fully charged 3A40BC fire extinguisher, working smoke & carbon monoxide detectors, fenced backyard, and no bodies of water. The Licensee states that she does not have any weapons in the home. The Licensee has two caged parakeets in the home. LPA reminded the Licensee that all pet food must be inaccessible to the day care children at all times. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. All poisons are inaccessible to children. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 05/29/2019):

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CERON, LEONOR	FACILITY NUMBER: 434403424
	VISIT DATE: 05/31/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 05/31/2019):

A review of staff records on May 29, 2019 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. LPA reminded the Licensee that there must be at least one qualified adult present with valid CPR & First Aid certifications in the home at all times. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time with a qualified assistant present. The Licensee states that she does not transport children. The Licensee states that she does not administer any medications.

No deficiencies issued during today's inspection.

LPA conducted an exit interview with the Licensee and advised her of the pending Department regulation update re: safe sleep for infant children. LPA referred the Licensee to the Department website: www.ccld.ca.gov for additional information.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2019

LIC809 (FAS) - (06/04)

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