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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013412058
Report Date: 03/01/2023
Date Signed: 03/01/2023 12:02:48 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/01/2023 12:02 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:LOMBARDO, MARIAFACILITY NUMBER:
013412058
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
03/01/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Maria Lombardo- LicenseeTIME COMPLETED:
12:15 PM
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On 03/02/22, Licensing Program Analyst Briana Plumboy, met with licensee Maria Lombardo for an UNANNOUNCED REQUIRED 1 YEAR INSPECTION. Present for this visit was 3 infants and 2 preschool age children. The home and front yard were toured to conduct a Health and Safety Inspection. Per licensee, the facility currently operates Monday through Thursday from 8:00am until 5:00pm.
The home is single story. The ON LIMIT AREAS are the living room, family room/play room, the 2 bedrooms, and the hallway bathroom located at the end of the hallway, and the front yard. The OFF LIMIT AREAS are the remainder of the home (kitchen, hallway bathroom located between the bedroom and second bathroom, and backyard) which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be the room off the left of the living room(master bedroom). The FRONT YARD play area is completely fenced. There are toys, play equipment, and learning materials. The front play yard is designed for children in care with cushioning and tarp covering the ground, and has multiple shaded areas. The areas are shaded by outdoor umbrellas, trees, and canopy's. There are no pools, hot tubs or any other bodies of water present during today's inspection. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible to children in care during today's inspection.
The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone, emergency supplies, and First Aid Kits. The licensee's CPR and First Aid certificate is current and expires 2/19/25. The licensee and her assistant Silvia Torres are in compliance with the immunization law which pertains to providers. The licensee's mandated reporter training is complete. The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home.
The licensee conducts and documents fire and disaster drills at least twice a year with the last one conducted on 01/18/23. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. See 809-C for continuance
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2023
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: LOMBARDO, MARIA
FACILITY NUMBER: 013412058
VISIT DATE: 03/01/2023
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Incidental Medical Services (IMS) policy was discussed. 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)/ (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

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensee Maria Lombardo 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 Maria Lombardo 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.

A notice of site visit was given and must remain posted for 30 days.

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Maria Lombardo.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC809 (FAS) - (06/04)
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