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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423883
Report Date: 02/07/2024
Date Signed: 02/07/2024 11:40:37 AM

Document Has Been Signed on 02/07/2024 11:40 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:JIMENEZ, ALBA & MONTESINOS, FERNANDOFACILITY NUMBER:
013423883
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/07/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Alba Jimenez and Fernando MontesinosTIME COMPLETED:
11:42 AM
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On 2/7/24, at 8:45am, Licensing Program Analyst (LPA) Catherine Fernandes arrived announced on a prelicensing inspection and met with applicants Alba Jimenez and Fernando Montesinos. Residing in the home are the two applicants. There is a finger print cleared adult living in a separate converted garage located in the back of the house. The home was toured to conduct a health and safety inspection. The applicants plan to operate between the hours of 7:30AM -5:30PM, Monday through Friday.
The home is a two story house that consists of five bedrooms, and three bathrooms, which is neat and clean with heating and ventilation for safety and comfort of the children. The entrance to the child care will be the through the fence through and at the side door of the home. LPA observed age appropriate toys that appear to be safe, clean and in good repair. There are no bodies of water or pools accessible to children during today’s inspection. LPA did not observe any hazardous materials or toxins, or medications accessible to children during today’s inspection. Per Applicants, there are no firearms or pets in the home. During today's inspection LPA observed the following precautions the kitchen and stairs in the home have safety gates to prevent access.
On-limit-areas are the: The two back bedrooms which will be the main areas of the day care, the bathroom thats near the two bedrooms, the dining/laundry area and the front area of the fenced in backyard.
Off-limit-areas are: The entire upstairs(two bedrooms, family room and bathroom), the converted garage, the fenced in area next to the garage, the right side of the backyard that is fenced off, the kitchen, the master bedroom located next to the living room, the living room and the master bathroom, which will be made inaccessible by closed and/or locked doors and visual supervision.
The Isolation area will be the table in the dining/laundry room away from other children in care.
There is a fully charged 2A10BC fire extinguisher in the home, a working smoke detector in the hallway next to the two on limit bedrooms and a carbon monoxide detector located in the dining/laundry room and the applicants have a working phone number.
Report continues on 809C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: JIMENEZ, ALBA & MONTESINOS, FERNANDO
FACILITY NUMBER: 013423883
VISIT DATE: 02/07/2024
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The applicants have current CPR certificates and have completed their mandated reporter training. The applicants are in compliance with the immunization laws which pertains to all childcare providers.
This home does not plan to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

LPA informed the applicants that all forms can be downloaded at www.ccld.ca.gov and encouraged the applicant to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The applicant was also reminded that Mandated Reporter Training is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

The applicants was provided information regarding effects of Lead Exposure.


LPA discussed the safe sleep regulations with applicant 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 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.

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

Report continues on 809C

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: JIMENEZ, ALBA & MONTESINOS, FERNANDO
FACILITY NUMBER: 013423883
VISIT DATE: 02/07/2024
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The applicants, has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 6 children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 8 children.

On this date 2/7/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicants were informed of the MyChildCarePlan.org site, 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.

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.

Before the license can be granted the applicants need to have a parent board in a visual area.



Exit interview conducted and report was reviewed with the applicants.

Report provided.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC809 (FAS) - (06/04)
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