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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413861
Report Date: 03/03/2022
Date Signed: 03/03/2022 02:51:40 PM


Document Has Been Signed on 03/03/2022 02:51 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:TUDELA, BEGONA & NECO, EDGARFACILITY NUMBER:
434413861
ADMINISTRATOR:TUDELA, B. & NECO, E.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 771-2347
CITY:MOUNTAIN VIEWSTATE: CAZIP CODE:
94040
CAPACITY:14CENSUS: 12DATE:
03/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Begona TudelaTIME COMPLETED:
03:10 PM
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On 03/03/2022 at 9:30am Licensing Program Analyst (LPA) Christina Uribe, met with licensees Begona Tudela & Edgar Neco for an UNANNOUNCED ANNUAL INSPECTION. Present for the inspection were 12 daycare children and one fingerprint cleared assistant, and the licensee is within ratio today. Upon arrival LPA provided licensee a copy of the Entrance Checklist (LIC 126). The home was toured to conduct a Health and Safety Inspection. The facility currently operates Monday-Friday 8:00am-5:00pm.

The home is a single story home with 3 bedrooms, one bathroom, living room, kitchen, dining area, garage and back yard. LPA observed the home to be neat and clean with central heating and ventilation for safety and comfort. All on/off-limit areas are consistent with the facility's pre-licensing reports.

The OFF-LIMIT AREAS are the master bedroom, kitchen, & garage and will be inaccessible to children by locked doors, safety gates and visual supervision.

The ON-LIMIT AREAS are the two additional bedrooms, bathroom, dining area, living room, and backyard that is used as the main daycare area. The designated isolation area is in one of the bedrooms. The backyard will be a designated outdoor play area with secured structures for play and is fully fenced. The outdoor area also has a covered enclosed area that is decorated with toys, tables, chairs, and learning manipulatives which are age appropriate observed to be clean and free from defects and dangerous conditions.

All hazardous materials and toxins are kept out of reach from children and are not accessible. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, carbon monoxide, telephone and fully stocked first aid kit. A separate inspection was performed by the City of Mountain View on 02/23/2022 and no violations were observed. A copy of the Fire Prevention Notice of Inspection was obtained. There are no pools, hot tubes or any other bodies of water present at the time of the inspection. Per licensee, there are no firearms on the premises. Facility does have two family dogs that are kept away from children in care.

***Continued on LIC 809C***

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Christina UribeTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2022
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: TUDELA, BEGONA & NECO, EDGAR
FACILITY NUMBER: 434413861
VISIT DATE: 03/03/2022
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The licensee completed the Health and Safety training, CPR/First Aid certification expires on 06/12/2023. The licensee is in compliance with the immunization laws and has completed the mandated reporter training on 09/08/2021.

The licensee conducts and documents fire and disaster drills twice a year and the last conducted drill was on 10/02/2021. All required forms are posted and visible for public review.

At 10:30am LPA Uribe reviewed 6 children’s files, facility file and documented on LIC 857. Individual Infant Safe Sleep Plans are complete and in child's file. The facility does meet the Infant Safe Sleep Regulations however they do not document the 15-minute checks. LPA Uribe showed licensee a sample of sleep charts which she began using today during the inspection for the sleeping infant and will keep the forms in the child's file. There is a current roster available for review and copy obtained. Staff interview also conducted and documented.



Incidental Medical Services (IMS) policy was discussed and the facility does not have any children with the need for medication to be kept at the facility at this time. 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: http://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.

***Continued on LIC809C***

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Christina UribeTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

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

DATE: 03/03/2022
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: TUDELA, BEGONA & NECO, EDGAR
FACILITY NUMBER: 434413861
VISIT DATE: 03/03/2022
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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 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.

Effective August 1, 2003 California Law requires Child Care Licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury Form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624, within 7 business days.

No violations are being cited during today's inspection. One advisory note is being issued today as a Technical Violation for the use of an infant Sleep Chart.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Begona Tudela.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Christina UribeTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

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

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