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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423851
Report Date: 12/28/2022
Date Signed: 01/03/2023 08:54:32 AM

Document Has Been Signed on 01/03/2023 08:54 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:WRIGHT, OLIVIA & MONTES-PAREDES, LESLIEFACILITY NUMBER:
013423851
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
12/28/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:02 AM
MET WITH:Olivia WrightTIME COMPLETED:
11:54 AM
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On December 28, 2022 at 9:02am Licensing Program Analyst (LPA) Indira Loza met with applicants Olivia Wright and Leslie Montes-Paredes to conduct a Change of Location inspection. The hours of operation will be 8am-5:30pm Monday through Friday.

The home is a single family home. The home consists of three bedrooms, two bathrooms, a kitchen, a dining room, and a living room. The two bedrooms are connected by a bathroom. There is a large backyard that is shared with the house behind the facility. The Off Limit areas will be the Applicant's bedroom to the left of the kitchen and the backyard. Applicant will ensure the off limit areas will be inaccessible by closed and/or locked doors, safety gates and visual supervision. The On Limit areas are both bedrooms and the bathroom on the left from the entrance, the living room and dining room which are on the right from the entrance, and the bathroom next to the kitchen. The isolation area will be in the bedroom to the left from the kitchen. The backyard will not be used for outdoor play, instead the front yard and park will be utilized for outdoor play.

The applicants plans on providing food for the children. The applicants stated there are no firearms in the home. The applicants plans on having Liability insurance. LPA observed a working carbon monoxide detector and a working smoke detector. There is a working phone in the home. The home is sanitary and orderly, with heating and ventilation for safety and comfort. The applicant has a current Mandated Reporter Certificate which expires on 11/7/2024. O. Wright has a current CPR/First Aid certificate which expires on February 2024. L. Montes-Paredes has a CPR certificate which expires on December 11, 2024 and the Mandated Reporter certificate expires on October 9, 2024 The applicants have a fully charged 3A40BC fire extinguisher.

LPA discussed the safe sleep regulations with the Applicant, and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as
***********************************************Report continues on 809-C*******************************************
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE: DATE: 12/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/28/2022
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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: WRIGHT, OLIVIA & MONTES-PAREDES, LESLIE
FACILITY NUMBER: 013423851
VISIT DATE: 12/28/2022
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an additional resource. LPA also informed applicant 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.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Individual Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.



Effective today, December 28, 2022, The License for a small family daycare will be granted.
Exit Interview conducted and report reviewed with Co-Licensee Olivia Wright.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2022
LIC809 (FAS) - (06/04)
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