013412902-5-9-2024-52-CC-BPLY-D54N67-20240509101039

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013412902
Report Date: 05/09/2024
Date Signed: 05/09/2024 10:10:44 AM

Document Has Been Signed on 05/09/2024 10:10 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	GUZMAN, ROSARIO		FACILITY NUMBER:	013412902
ADMINISTRATOR/ DIRECTOR:	ROSARIO GUZMAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 516-8261
CITY:	UNION CITY	STATE: CA	ZIP CODE:	94587
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 3	CENSUS: 0	DATE:	05/09/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:20 AM
MET WITH:	Rosario Guzman- Licensee		TIME VISIT/ INSPECTION COMPLETED:	10:20 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	On 05/9/24, Licensing Program Analyst Briana Plumboy, met with licensee Rosario Guzman for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was fingerprint clear and associated adult J.Guzman. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 6:00am until 6:00pm, and per licensee, she is flexible with the families. The home is single story. The home has heating and ventilation for safety and comfort. The ON LIMIT AREAS are the hallway bathroom, living room, and enclosed day care room. The OFF LIMIT AREAS are the 3 bedrooms, family room, master bathroom, kitchen/dining room, and garage which will be inaccessible by closed and/or locked doors and visual supervision. The ISOLATION AREA will be an area located inside the day care room. The BACKYARD is completely fenced for for children's use. There are toys and learning materials present. There are no pools, hot tubs or any other bodies of water present in the on limits areas 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 during today's inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. Licensee has a current CPR and First Aid certificate which expires 07/15/24. The licensee's mandated reporter training is complete. There are no heaters or fireplaces in the home. Per licensee, there are no firearms in the home. The licensee has not conducted or documented a fire and/or disaster drill due to not having children enrolled in the childcare at this time except her grandchildren. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. See 809-C for continuance

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GUZMAN, ROSARIO	FACILITY NUMBER: 013412902
	VISIT DATE: 05/09/2024

NARRATIVE

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Licensee Rosario Guzman is aware she should have knowledge of all Title 22 Regulations and follow all Title 22 Regulations at all times, as well as follow manufacture guidelines for all equipment in the facility.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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

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-carelicensing/subscribe and select the Child Care option to receive email communication.

Licensee Rosario Guzman was reminded that all adults 18 and over living or working in the home, 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.

See 809-C for continuance

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GUZMAN, ROSARIO	FACILITY NUMBER: 013412902
	VISIT DATE: 05/09/2024

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Licensee Rosario Guzman was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA discussed the safe sleep regulations with licensee Rosario Guzman and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed licensee Rosario Guzman 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.

During the exit interview, the Licensee Rosario Guzman confirmed that there are no Registered Sex Offenders living in the facility.

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

No deficiencies today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Rosario Guzman.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

LIC809 (FAS) - (06/04)

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