434414551-8-9-2023-07-CC-TTRO-CUJPUP-20230809113753

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414551
Report Date: 08/09/2023
Date Signed: 08/09/2023 11:38:00 AM

Document Has Been Signed on 08/09/2023 11:38 AM - 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:	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: 6	DATE:	08/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:23 AM
MET WITH:	Isela Marysol Flores Garcia		TIME COMPLETED:	11:45 AM

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On 08/09/2023 at 08:23 AM, Licensing Program Analyst (LPA) Teodoro Trujillo met with licensee Isela Flores Garcia, for an annual inspection. Present with licensee were assistant Leydi and her two minor children, with 6 children: six (6) preschool age, two additional preschool age children arrived during site inspection. Adults living in the home are licensee, her spouse Oliver and her two minor children ages 15 and 13 years old. Days and hours of operation are Monday through Friday 07:45 AM to 05:30 PM.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 5/08/2023 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. 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 inspected inside and outside of single-story home. Licensee owns the home and Licensee states she has liability insurance for a family childcare home (FCCH). LPA observed a 2A10BC fire extinguisher last purchased on 01/31/2023. Carbon Monoxide and smoke detectors are operable. LPA observed no wall heater, two blocked fireplaces back-to-back: one in the living room and another in the day care room. 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 off limit 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 and security alarm for the front door. Off limits indoor: master bedroom, master bathroom, three bedrooms, laundry room and the attached garage. Off Limit outdoor: gated swimming pool with storage shed, gated left side of house.

Children were supervised during the visit and LPA went over substitute options and reminded licensee they could only have 14 children according to her license. Licensee stated she does not transport children, LPA reminded Licensee that children are never to be left in parked vehicles and must use appropriate car seats according to the child's age/weight/size.

No deficiencies were cited during today's visit. Exit interview conducted and report was reviewed in Spanish with the licensee, Isela Flores Garcia. 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.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Teodoro Trujillo	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023

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: 08/09/2023

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Continuation of report dated 08/092023 pg. 2/2

LPA observed a current roster of the children. LPA observed a fire and disaster drill log last performed on 05/23/2023. LPA reviewed 5 children’s files and observed all required documentation was in compliance. Infant individual sleeping plan (LIC 9227) for each infant under 12 months was discussed. LPA observed licensee completed Mandated Reporter Training on 08/26/2021. Licensee has Pediatric CPR/1^st Aid expiring on 01/02/2025. Needed documentation for SB 792 which requires immunization against Pertussis, Measles, and Influenza as well as TB testing is current for licensee, and all adults residing in the home.

Incidental Medical Services (IMS) policy was discussed with the licensee. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The licensee is not providing IMS currently. Licensee will submit an updated plan of operation if in the future they provide any IMS services to a child in care.

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.

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.

Continues report dated 08/092023 pg. 2/2

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Teodoro Trujillo	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023

LIC809 (FAS) - (06/04)

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