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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413941
Report Date: 07/21/2022
Date Signed: 07/21/2022 12:54:26 PM


Document Has Been Signed on 07/21/2022 12:54 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:MANGALINDAN, ELIZABETH & RODRIGUEZ, THERESAFACILITY NUMBER:
434413941
ADMINISTRATOR:MANGALINDAN & RODRIGUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 821-0751
CITY:SUNNYVALESTATE: CAZIP CODE:
94089
CAPACITY:14CENSUS: 13DATE:
07/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Elizabeth Mangalindan & Theresa RodriguezTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Mel Matos met with Elizabeth Mangalindan & Theresa Rodriguez, Licensees, for an unannounced Required – 1 year annual inspection. LPA was granted access to the home by the Licensees. LPA also observed thirteen children (1 infant, 10 preschool, & Elizabeth's two children - ages 4 & 9 years of age) in the home during today's inspection. Licensees were operating within the capacity and ratio requirements. LPA observed the required postings, including the facility license, near the front entrance to the home. Days and hours of operation are Monday - Friday from 8:00 AM to 5:00 PM. Adults residing in the home are: Licensees, Benjie Mangalindan (Elizabeth's spouse), Joseph Rodriguez (Theresa's spouse), Andrew Bui (Licensees' brother), and Anh Nguyen (Licensee's sister-in-law).

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on July 8, 2022. Licensees state that they have liability insurance for the day care through DCI insurance. Licensees have current CPR and First Aid certifications (expiration: 01/22/2024). Licensees have the required vaccines (MMR, Tdap, & flu) and are current with their Mandated Reporter Training for Child Care Workers (expiration: 01/26/2024). LPA reviewed eleven children's files and the files were complete with the required forms. LPA reviewed two staff files (Licensees) and the files were complete with the required forms.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensees have a working telephone in the home. The home is clean, orderly, (including heating/air conditioning/ventilation), and safe for the day care children. There are safe & age appropriate toys, play equipment, and materials for the children in the home. There are no stairs or wall heater units inside the home. Off limit areas inside the home: three bedrooms, barricaded fireplace (located in the living room), and attached garage. Off limit areas outside the home: left side yard and back section of the backyard.

LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. Licensee states that they do not have any weapons or pets in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Any poisons are locked and inaccessible to the day care children. . Licensees state that they do not administer any medications to the day care children at this time.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: MANGALINDAN, ELIZABETH & RODRIGUEZ, THERESA
FACILITY NUMBER: 434413941
VISIT DATE: 07/21/2022
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Licensees state that parents provide AM/PM snacks and lunch for the day care children. Licensees understand that any food brought from home shall be labeled with each child's name and properly stored. Licensees have a first aid kit in the home which includes a touch less thermometer. Licensees understand that smoking is prohibited in the home.

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: http://www.ada.gov/childqanda.htm

Supervision of children was discussed with the Licensees and they understand that they must be present in the home during day care hours and ensure that the children are supervised at all times. Licensees understand the capacity/ratio options and they understand that they cannot have more than 14 children present in the home without at least two qualified adults present. Licensees state that a child will be isolated in the living room area if necessary due to illness or communicable disease. Licensees state that they not transport any day care children. Licensees understand that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Licensees were 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 the Licensees 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 the Licensees 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.

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

Exit interview conducted and report was reviewed with the Licensees, Elizabeth Mangalindan & Theresa Rodriguez. No deficiencies issued during today's inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022
LIC809 (FAS) - (06/04)
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