013418031-1-8-2024-52-CC-MPRE-CZAS44-20240108123206

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013418031
Report Date: 01/08/2024
Date Signed: 01/08/2024 12:32:14 PM

Document Has Been Signed on 01/08/2024 12:32 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:	CAMACHO, MIREYA SOSA & DIAZ, YOLANDA DUENAS		FACILITY NUMBER:	013418031
ADMINISTRATOR:	CAMACHO, MIREYA SOSA &		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 512-3759
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94545
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 6	CENSUS: 6	DATE:	01/08/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Mireya Sosa Camacho		TIME COMPLETED:	12:30 PM

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 1/8/2024 at 10:00am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Mireya Sosa Camacho for a Required – 3 Year Inspection. Her co-licensee Yolanda Duenas Diaz was not present. Present during the inspection was the Licensee, two (2) infants and four (4) preschool age children. Licensee Diaz is the daughter in-law of Licensee Camacho. Licensee’s live in the home with Jose Briseno Sosa (Diaz’s husband and Camacho’s son), Jose Briseno (Diaz’s father in-law and Camacho’s husband), and Camacho's two (2) minor sons age fourteen (14) and twelve (12). The facility operates 6:00am – 5:00pm, Monday – Friday. ON LIMITS AREA: Two (2) Playrooms, Converted Garage (kitchen and sitting area only), Master Bedroom and Bathroom next to playroom and Front Yard OFF LIMITS AREA: Main House: Three (3) bedrooms, Kitchen, Living Room, one (1) bathroom, Bedroom and Bathroom in converted Garage, and Backyard ISOLATION AREA: Converted Garage Sitting Area The facility is single story home owned by Mireya Sosa Camacho. The inside of the home is observed to be neat, clean with ample age-appropriate materials for the children. Licensees use the gate on the side of the home as the entrance. All toxins, cleaning products, personal medications, and hazardous materials were observed to be in inaccessible areas. Licensee stated that they provide all food for the children. All food that is brought from the children’s home will be properly labeled and stored. All materials used for eating was observed to be clean and free from defects. LPA observed child sized mats and four (4) play yards used for napping that were clean, free from defects and properly stored. All children’s bedding was observed to be clean and properly stored. All off limit areas are made inaccessible with gates, locks, and closed doors. Licensee stated they do not transport children. There are four (4) dogs that remain in the off-limit parts of the home and no firearms. Page 1 of 4

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024

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 4

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: CAMACHO, MIREYA SOSA & DIAZ, YOLANDA DUENAS	FACILITY NUMBER: 013418031
	VISIT DATE: 01/08/2024

NARRATIVE

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The home has one (1) fully charged 3A40BC fire extinguisher in the playroom closest to the kitchen. There is one (1) working smoke/carbon monoxide detector in each playroom, one (1) smoke detector in the kitchen, and an additional working carbon monoxide detector in the playroom closest to the kitchen. The home is equipped with central heat and air for proper ventilation. The front yard is fully fenced with ample age-appropriate materials for the children. LPA did not observe any harmful bodies of water in or around the home.

The facility is operating within its licensed capacity and is in ratio. Licensees Health and Safety training's have been completed and EMSA approved Pediatric CPR & First Aid has been completed and expires 10/10/2024. Licensees Mandated Reporter training's are complete and expire 8/19/2025. Fire/disaster drills have been conducted and documented, with the last drill logged on 10/4/2023. All required postings are made visible by the sliding glass door that leads to the main house. All adults living and working in the home have obtained a criminal record clearance. LPA obtained the facility roster, facility files and children’s files. All files were complete.

No deficiencies were cited during this inspection.

Licensee was reminded that California law requires Licensees to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone. Within seven (7) days from the incident, Licensee’s must submit the Unusual Incident/Injury form (LIC 624B) to the Department. Licensee was reminded that any structural changes or additions to the home must be reported to Community Care Licensing. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting https://mandatedreporterca.com/. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: CAMACHO, MIREYA SOSA & DIAZ, YOLANDA DUENAS	FACILITY NUMBER: 013418031
	VISIT DATE: 01/08/2024

NARRATIVE

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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)/ (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 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.

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

During the exit interview, Licensee Mireya Sosa Camacho, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

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SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: CAMACHO, MIREYA SOSA & DIAZ, YOLANDA DUENAS	FACILITY NUMBER: 013418031
	VISIT DATE: 01/08/2024

NARRATIVE

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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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

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

Exit interview conducted and report was reviewed with the Licensee Mireya Sosa Camacho.

page 4 of 4

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4