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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420414
Report Date: 11/30/2023
Date Signed: 11/30/2023 12:10:21 PM

Document Has Been Signed on 11/30/2023 12:10 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ARANDA, LORENAFACILITY NUMBER:
013420414
ADMINISTRATOR:ARANDA, LORENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 387-9728
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
11/30/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Lorena ArandaTIME COMPLETED:
12:20 PM
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On November 30, 2023 at 9:05am Licensing Program Analyst (LPA) Indira Loza met with Licensee Lorena Aranda the purpose of conducting an unannounced 3-year annual inspection. Present during today's inspection were the Licensee, her fingerprint cleared assistant - Maria Pureco, 4 infants, and two preschool-age children. The operating days and times are Monday - Friday 8am-5pm. The home was toured for a health and safety check.

The home is a single family home consisting of four bedrooms, two bathrooms, kitchen, living room, dining area, garage, and fully fenced in backyard.

On Limit Areas - The two bedroomsat the far end of the home, living room, kitchen, dining area, bathroom in the hallway, and the backyard.
Off Limit Areas - The two bedrooms and bathroom which are to the left in the hallway.
ISOLATION AREA - is in the kitchen

The home has a fully charged 3A40BC fire extinguisher, a working smoke detector in the kitchen, a working carbon monoxide detector in the dining area, and a working telephone. The Licensee stated she has Liability Insurance. The Licensee had a current Mandated Reporter Certificate which expires on June 14, 2025. The Licensee has a current CPR certificate which expires September 2025. The home has heating and ventilation for safety and comfort. The Licensee has ample age-appropriate toys and learning materials in the home and in the backyard. Toxins, medicines, and hazardous items were inaccessible during today's inspection. There were no bodies of water present on the premises. Per the Licensee there are no firearms in the home.

LPA provided the Licensee with the Infant Safe Sleep Regulations and a copy of the "Individualized Safe Sleep Plan" (LIC 9227) was provided and reviewed. LPA assisted the Licensee with signing up to receive Provider Information Notifications (PINS)
**********************************Report Continues on LIC 809-C*******************************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2023
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ARANDA, LORENA
FACILITY NUMBER: 013420414
VISIT DATE: 11/30/2023
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Incidental Medical Services (IMS) policy was discussed. The Licensee is currently not providing IMS to the children in care. For IMS information see PIN 22-02. When any IMS is 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 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 onFamily 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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

During the Exit Interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.



**********************************Report Continues on LIC809-C********************************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ARANDA, LORENA
FACILITY NUMBER: 013420414
VISIT DATE: 11/30/2023
NARRATIVE
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There were no deficiencies issued during today's visit.

Exit interview conducted and report was reviewed with Lorena Aranda.
Report and Appeal Rights were provided.
A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023
LIC809 (FAS) - (06/04)
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