434408542-6-20-2022-52-CC-MESA-CFKR4C-20220620124118

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434408542
Report Date: 06/20/2022
Date Signed: 06/20/2022 12:41:24 PM

Document Has Been Signed on 06/20/2022 12:41 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	TAPIA, ARACELI		FACILITY NUMBER:	434408542
ADMINISTRATOR:	TAPIA, ARACELI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 770-9035
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY:	14	CENSUS: 6	DATE:	06/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Araceli Tapia		TIME COMPLETED:	01:00 PM

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 Monday, June 20, 2022 10 am, Licensing Program Analyst (LPA) Manel Estoesta conducted a unannounced Required 1 Year visit. LPA met with the Licensee Araceli Tapia and explained the nature of site visit. Present on this visit were Licensee's assistant Antonia, 5 preschool children and an infant child. Facility operates from Monday and Friday 7am to 5pm. LPA toured the home and conducted a Health and Safety Inspection with the Licensee. Licensee is in compliance of the posting requirements. On limits are the gated court front yard, family room, living room, kitchen, hallway bathroom and backyard. Off limit areas in the home are the three bedrooms, the master bathroom, and the Garage. The home was clean and orderly, with heating and ventilation for the safety and comfort of children in care. The observed children’s toys, play equipment and materials were safe and age appropriate. Furniture and equipment, such as tables, chairs, play pens, feeding chairs, and step stool were age appropriate and in good condition. There were no baby walkers observed. The backyard is fenced and is used as outdoor activity space. Outdoor activity space and play equipment were observed to have been maintained in safe condition and free of hazards. Storage areas in the backyard were fenced off to prevent children from accessing. There were no bodies of water observed. Licensee stated that there were no weapons such as firearms stored on the premise. Disinfectants, cleaning solutions, sharps, and other items that are dangerous to children in care were stored inaccessible, out of reach, of children. Facility appeared to be free of flies, other insects, and rodents during today’s inspection. A working fire extinguisher, and carbon monoxide and smoke detectors were observed. Log shows that the last Fire and Earthquake Drill was conducted on 02/17/2022. Licensee owns the house and maintain signed the forms LIC 282 AFFIDAVIT REGARDING LIABILITY INSURANCE 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: 06/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: TAPIA, ARACELI	FACILITY NUMBER: 434408542
	VISIT DATE: 06/20/2022

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The licensee and Licensee's Assistant's CPR and First Aid certificate is current. The licensee and Licensee's Assistant's completed the AB 1207 Mandated Reporter General Training and Child Care Providers training online a https://mandatedreporterca.com/. 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.

Facility roster of children was reviewed, and a copy was obtained. 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.

Licensee stated that she does not transport children at this time. Licensee has a current and valid Driver License. Licensee understands that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children in care shall be maintained in safe operating conditions and all vehicle occupants must be secured in an appropriate restraint system.

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 PIN 22-10 CCP and PIN 20-24 CCP.

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: 06/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: TAPIA, ARACELI	FACILITY NUMBER: 434408542
	VISIT DATE: 06/20/2022

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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.

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, Araceli Tapia.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Manel Estoesta	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022

LIC809 (FAS) - (06/04)

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