434414551-11-21-2019-07-CC-JTSE-BJ63DR-20191121170958

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414551
Report Date: 11/21/2019
Date Signed: 11/21/2019 05:10:09 PM

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:	FLORES GARCIA, ISELA MARYSOL		FACILITY NUMBER:	434414551
ADMINISTRATOR:	FLORES GARCIA, ISELA MARYS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 498-0496
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY:	14	CENSUS: 12	DATE:	11/21/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Isela Marysol Flores Garcia		TIME COMPLETED:	05:15 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	LPA Janet Tse met with licensee Isela Marysol Flores Garcia for an annual/random inspection. LPA explained the nature of today's visit to Licensee. Present were 12 children including one infant with Licensee, her two assistants, Heidi Melgar and Denisse Bautista Flores who is also Licensee's daughter. Adults living in the home are Licensee, her husband, her daughter, with two children ages 12 and 9 1/2. Days and hours of operation are Monday to Friday, 7:00am to 5:30pm. LPA toured the indoor and outdoor of the home. LPA observed two blocked fireplaces back to back: one in the living room and another in the day care room. Off limits indoor: master bedroom, master bathroom, three bedrooms, laundry room and the garage. Licensee stated there is no firearms/weapons in the home. Sharp objects, medicines, poisons and cleaning supplies are inaccessible to the children. Backyard is fenced. LPA observed a fenced swimming pool with a self latching gate in the backyard. There are also security alarms for the sliding doors in the dining room, master bedroom, and Licensee's daughter's bedroom to the backyard. A security alarm was also installed for the front door. There is no pets in the home. Off limits outdoor: the fenced off gated swimming pool area. LPA observed a storage shed in the off limits fenced swimming pool area. LPA reminded licensee that she can only have 14 children according to her license. Fire extinguisher is size 2A10BC and filled. Smoke and carbon monoxide detector is operable. Home is clean and orderly with heating and ventilation for safety and comfort. LPA observed sufficient materials, toys, and play equipment for the day care children. Telephone is in working order. Children were supervised on the visit and LPA went over substitute options. LPA also discussed if licensee transports children, they are never to be left in parked vehicles. A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 11/18/2019 was reviewed; and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. Facility Evaluation Report dated 11/21/2019 to be continued on next page:

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019

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: FLORES GARCIA, ISELA MARYSOL	FACILITY NUMBER: 434414551
	VISIT DATE: 11/21/2019

NARRATIVE

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Facility Evaluation Report dated 11/21/2019 to be continued from previous page:

A copy of the current roster of the children was provided to LPA today. LPA reviewed 12 children's files. LPA observed in each child’s record has a copy of the emergency information card that contains all of the information specified by regulation. LPA observed that Licensee and her two assistants Heidi Melgar and Denisse Bautista have current Pediatric CPR/1^st Aid expiring 09/21/2021, 02/23/2021, and 02/19/2020 respectively.

Licensee was given the list of current forms for childcare. Website to download forms and to review regulations: http://www.ccld.ca.gov.

LPA discussed the immediate civil penalties for Zero Tolerance of $500, and an ongoing $100 per day per violation continues until the violation(s) is corrected. LPA also discussed the Healthy Beverage Act and AB633 requirements for type A violation. AB792 Immunization Requirements was discussed. LPA observed the required immunization records for Licensee and her assistants were in file.

Effect of Lead Exposure handout dated 1/20/19 given during today’s inspection. Licensee understands that per Assembly Bill (AB 2370), written information regarding lead exposure needs to be given out to enrolling and re-enrolling parents or guardians. LPA reviewed infants safe sleep policies with Licensee and provided "A Child Care Provider's Guide to Safe Sleep.” More information can be found at https://cdss.ca.gov/inforesources/Child-Care-Licensing. Incidental Medical Services were discussed with the licensee. The licensee is not providing IMS (Incidental Medical Services) at this time. Licensee will submit an updated plan of operation if in the future they provide any IMS services to a child in care.

The Mandated Reporter AB1207 Compliant Child Care Training was also discussed. Website to complete training: https://mandatedreporterca.com. Licensee's primary language is Spanish and is currently exempt from the training.

Website for provider resources: https://cdss.ca.gov/inforesources/Child-Care-Licensing. Periodic information releases accessible by signing up at: www.myccl.ca.gov.

No deficiency was cited. Notice of site visit was issued and must be posted for 30 days.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019

LIC809 (FAS) - (06/04)

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