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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416711
Report Date: 04/22/2022
Date Signed: 04/22/2022 12:09:00 PM


Document Has Been Signed on 04/22/2022 12:09 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:DURAN, LIGIAFACILITY NUMBER:
434416711
ADMINISTRATOR:DURAN, LIGIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 628-2704
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY:14CENSUS: 4DATE:
04/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Ligia DuranTIME COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA) James Santos conducted an unannounced Required 1 Year Inspection at the day care home today and met with Licensee, Ligia Duran and stated the purpose of the visit.

Day care home's operation schedule is M-F from 8am-2pm. There are 5 individuals residing in the home: Licensee and her husband and 3 minor children.

LPA inspected the home inside the out. The off limit areas inside the home: upstairs area, kitchen area and garage. The home has a fire extinguisher, fire alarm and also carbon monoxide and smoke detectors. LPA observed sufficient toys and play equipment for the day care children. Bathroom for children was observed to be clean and sanitary. Chemicals and cleaning solutions are all stored and inaccessible to children. Per Licensee, they don't have firearms and ammunition stored in the home. There is a fireplace in the home which is covered in glass and not being used.

The outside play area is surrounded by fence and was observed to be free of any hazards. No bodies of water were observed. Off limit area outside is the side yard walk way which is gated.

LPA reviewed the current Child Care Facility Roster and children's records during today's inspection. The records reviewed include but not limited to emergency contact information, immunization records, consent for medical treatment and parent's rights. Emergency Disaster Drill Log was reviewed and the last drill was conducted in November 2021.

Licensee's and assistant's record was reviewed. Licensee's CPR/1st Aid certification is valid through December 2022 and her Mandated Reporter Training certification is valid through 2/10/2023 and for her assistant is until April 2023.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G SantosTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:
DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/22/2022
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: DURAN, LIGIA
FACILITY NUMBER: 434416711
VISIT DATE: 04/22/2022
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LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearance, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

LPA discussed and provided Licensee with Safe Sleep information in case she will admit infants in the future. Per Licensee, they do not provide incidental medical service and they do not transport children.

Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online Licensing Forms, Adoption of new Laws, etc.

LPA advised Licensee of the required "mandated reporter" training for Assembly Bill, AB 1207 requirement for Child Care Providers that all staff must complete and renew every two (2) years. The website for the online training is: http://www.mandatedreporterca.com

No deficiencies cited. Exit interview conducted and report was reviewed with the Licensee.



NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: James G SantosTELEPHONE: (408) 334-8556
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
LIC809 (FAS) - (06/04)
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