434414790-5-22-2023-07-CC-MSMS-CS3NLM-20230522103347

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434414790
Report Date: 05/22/2023
Date Signed: 05/22/2023 10:33:54 AM

Document Has Been Signed on 05/22/2023 10:33 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:	OLIVERA, LAURA MICHELE		FACILITY NUMBER:	434414790
ADMINISTRATOR:	LAURA MICHELE OLIVERA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 498-0087
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94089
CAPACITY:	14	CENSUS: 3	DATE:	05/22/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Laura Michelle Olivera		TIME COMPLETED:	10:40 AM

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	Licensing Program Analyst (LPA) Mel Matos met with Laura Michelle Olivera, Licensee, for an unannounced Required – 1 year annual inspection. LPA notes that the Licensee resides in the Arches Apartment Homes in Building 18, Unit 137 (lower unit). LPA was granted access to the home by the Licensee. LPA also observed three day care children (2 infants & 1 preschool) in the home during today's inspection. Licensee was operating within her capacity and ratio requirements. LPA observed the required postings, including the facility license, near the front entrance to the day care. Days and hours of operation are Monday - Friday from 8:00 AM to 5:30 PM. The Licensee is the only adult residing in the home. Licensee has two minor children residing in the home (ages 6 and 1.5 years of age). 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 January 3, 2023. Licensee states that she does not have liability insurance for the day care and provides all families with the Affidavit Regarding Liability Insurance - Family Child Care Homes (LIC 282) form. Licensee has current CPR and First Aid certifications which are valid through May 2023. Licensee has the required vaccines (MMR, Tdap, & flu - opt out) and is current with her Mandated Reporter Training for Child Care Workers (exp: 05/19/2023). LPA reviewed five children's files and the files were complete with the required forms, including the Individual Infant Sleeping Plan (LIC 9227). LPA reviewed one staff file (Licensee) and the file was complete with the required forms. Licensee states that a child will be isolated in the living room area if necessary due to illness or communicable disease. LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home. The home is clean, orderly, (including central heating/air conditioning/ventilation), and safe for the day care children. There are safe and age appropriate toys, play equipment, and materials for the children in the home. LPA did not observe any wall heaters units and fireplace units inside the home. Off limit areas in the home: one closet in the bedroom. There are no stairs inside the home. Off limit areas outside the home: outdoor patio area. There are stairs outdoors within the apartment complex and LPA advised the Licensee that the day care children must be supervised at all times whenever they are outdoors. LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, and fenced patio area. There is a swimming pool in the middle of the complex that is appropriately fenced with a self-latching gate. The Licensee states that the day care children don't use the swimming pool. The Licensee states that she does not have any weapons or pets in the home. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. Any poisons are locked and inaccessible to the day care children.

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

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: OLIVERA, LAURA MICHELE	FACILITY NUMBER: 434414790
	VISIT DATE: 05/22/2023

NARRATIVE

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Licensee states that she provides all the meals (snacks and lunch) to the day care children. Licensee states that some parents will provide food for the children. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored. Licensee has a first aid kit in the home which includes a touch less thermometer. Licensee understands that smoking is prohibited in the home. Licensee states that she does not administer any medications to the day care children at this time.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity/ratio options and she understands that she cannot have more than 14 children present in the home without at least two qualified adults present. Licensee states that does transport day care children on an as needed basis at this time. Licensee understands 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.

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.

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 Licensee, . 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 Stephenson	TELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023

LIC809 (FAS) - (06/04)

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