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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415784
Report Date: 12/16/2024
Date Signed: 12/16/2024 12:34:53 PM

Document Has Been Signed on 12/16/2024 12:34 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:HEREDIA ANTON, MARIAFACILITY NUMBER:
434415784
ADMINISTRATOR/
DIRECTOR:
HEREDIA ANTON, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 630-9036
CITY:PALO ALTOSTATE: CAZIP CODE:
94301
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
12/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Heredia Anton, MariaTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 12/16/2024 at 10:45am, Licensing Program Analyst (LPA) Jialing “Julianne” Zhu met with licensee Maria Heredia Anton for an unannounced annual inspection. Present during the inspection were licensee, three (3) fingerprint-cleared assistants, and 11 children (3 infants and 8 preschoolers) in care. Also present were licensee’s adult daughter, who assisted with translations during the inspection as Licensee speaks primarily Spanish. 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’s current hours of operation are Monday - Friday from 8:00am - 5:00pm.

The home is a single-story duplex. The duplex next door is also a licensed child care facility. Licensee is aware and ensures the children between the two facilities are not shared or comingle. The on-limit areas are the entire front and back yards (primary day care space), enclosed patio, play room, living room (used mainly as walkthrough to access the backyard from inside the home), and bathroom. The off-limit areas are the kitchen and bedroom, which will be inaccessible by closed and/or locked doors and visual supervision. The isolation area is the living room. When a child shows signs of illness, he/she will be separated from other children here.

The inside of the home is observed to be clean and orderly, with central heating and ventilation for safety and comfort. LPA observed there are ample safe and age-appropriate toys, play equipment and materials. All toxins, cleaning products, and hazardous materials have been made inaccessible to the children. There are no firearms and no pets in the home.

There is a fully charged 3A40BC fire extinguisher in kitchen. LPA observed at least one working smoke and carbon monoxide detector in the home. The home is equipped with telephone service and a fully stocked first aid kit.

Page 1 of 3. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HEREDIA ANTON, MARIA
FACILITY NUMBER: 434415784
VISIT DATE: 12/16/2024
NARRATIVE
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LPA observed appropriate napping equipment at the facility. Children bring their own bedding and is taken home weekly for washing. Licensee provides AM/PM snacks and lunch for the children. All beddings and food brought from children’s home are be labeled with the children’s name and stored appropriately.

The outdoor play and learning areas are the front and backyards, which are completely fenced with visual supervision. When weather permits, children mainly are in the outdoor areas. The outdoor areas are free from defects or dangerous conditions. There is an ample supply of age-appropriate toys and activities available for children, and they are in good condition. There is ample shade available, and gates are locked at all times while children are in the backyard.

The licensee completed the Health and Safety training. The licensee’s Pediatric CPR/First Aid certification is current and expires on 11/25/2025. Licensee has completed the Mandated Reporter training for Child Care Providers and expires on 04/25/2025. The licensee is in compliance with the immunization laws. All adults living in the home have obtained a criminal record clearance.

LPA reviewed six (6) children’s files and three (3) staff files. There is a current roster available for review. The licensee conducts and documents fire and disaster drills at least once every six months, and the last conducted drill was on 12/09/2024. All required documents are posted and visible for public review. The licensee rents the property. The facility does not have liability insurance, and the Affidavit Regarding Liability Insurance forms (LIC 282) were reviewed.

Licensee was reminded that California Law requires 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 624B). Any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Incidents must be reported within 24 hours by phone, fax, or email. LPA informed the Licensee that all forms can be downloaded at www.ccld.ca.gov.

Licensee was also reminded that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years.

Page 2 of 3. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: HEREDIA ANTON, MARIA
FACILITY NUMBER: 434415784
VISIT DATE: 12/16/2024
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Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No deficiencies cited during today's inspection. Two (2) Advisory Notes were issued:

· 1 of 3 staff files reviewed by LPA did not have proof of immunization for MMR.

· 1 of 6 children's files reviewed by LPA did not have proof of immunization for 4th DTaP.

A Notice of Site Visit was given and must remain posted for 30 days. Exit interview was conducted, report was reviewed, and Appeal Rights were provided to licensee Maria Heredia Anton.

Page 3 of 3. End of Report.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC809 (FAS) - (06/04)
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