<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700259
Report Date: 02/22/2023
Date Signed: 02/22/2023 11:10:04 AM

Document Has Been Signed on 02/22/2023 11:10 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:MARCISCANO-BETTIS, RAIZAFACILITY NUMBER:
015700259
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
02/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Raiza Marciscano-BettisTIME COMPLETED:
11:20 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 February 22, 2023, Licensing Program Analyst (LPA) Simerjit Kaur arrived at the facility to conduct UNANNOUNCED RANDOM REQUIRED 1 YEAR SITE INSPECTION. LPA met with licensee Raiza Marciscano-Bettis. Upon initial arrival there were no children present. Present during the inspection, 1 infant age child arrived. Also residing in the home is licensee’s finger print cleared and associated husband and 2 minor daughters. Hours of operation for child care are Monday through Friday, 7:30am to 5:30pm. The facility is a two story house. The following was observed during today’s inspection:

The home is two story and consists of a kitchen, living room, three bedrooms, two bathrooms, half bathroom, laundry room, office, converted garage, basement, backyard, storage and work shop.



ON LIMIT AREAS (accessible to children in care): the converted garage (day care room), half bathroom located next main entrance door, and backyard. The isolation area will be in the corner of day care room. The converted garage (day care room) is neat and clean with heating and ventilation for safety and comfort.

OFF LIMIT AREAS (not accessible to children in care): the kitchen, living room, two bedrooms, two bathrooms, office, basement, laundry room, entire second floor. There is covered pool and hot tub in the backyard. The off limit areas will be inaccessible by closed and/or locked doors and visual supervision. The applicant was advised to contact Licensing Department, so that an inspection can be completed prior to changing an off-limits area to on-limits.
Continued on LIC 809C.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2023
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 6
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: MARCISCANO-BETTIS, RAIZA
FACILITY NUMBER: 015700259
VISIT DATE: 02/22/2023
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
26
27
28
29
30
31
32
EMERGENCY PREPAREDNESS/SAFETY: Facility has a fully charged 2A10BC fire extinguisher. Smoke and carbon monoxide detectors were tested and found to be functioning. A fire/disaster drill was last conducted on 11/3/2022 and meets the six month requirement. Facility has working telephone service. Per licensee, there are no firearms in the home. Per licensee the Emergency Disaster Plan is current.
STAFF/CHILDREN RECORDS REVIEW: Licensee and all adults living and/or working in the home have proper criminal background clearances. Licensee has registered for CPR/First Aid training course on 3/4/23. Licensee’s mandated reporter training is competed on 2/2/2023. A facility roster is maintained and a copy obtained.

LICENSING POSTING (required): All REQUIRED forms are posted and visible for public review: Facility license, Notification of Parents’ Rights, Earthquake Preparedness, Emergency Disaster Plan. Licensee was reminded that exersaucers, baby walkers, bouncers, jumpers, and similar items are not allowed and that smoking is prohibited in the home during day care hours.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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, 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.

Continued on LIC 809C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: MARCISCANO-BETTIS, RAIZA
FACILITY NUMBER: 015700259
VISIT DATE: 02/22/2023
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
26
27
28
29
30
31
32
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.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.



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/process.o

See 809D for deficiencies. A notice of site visit was given and must remain posted for 30 days. Appeal Rights are provided. Exit interview conducted and report was reviewed with the licensee Raiza Marciscano-Bettis.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 02/22/2023 11:10 AM - It Cannot Be Edited


Created By: Simerjit Kaur On 02/22/2023 at 09:55 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MARCISCANO-BETTIS, RAIZA
FACILITY NUMBER: 015700259

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/22/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above. Licensee does not have proof of MMR, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2023
Plan of Correction
1
2
3
4
Licensee shall provide proof of MMR to LPA by 3/15/23.
Type B
Section Cited
CCR
102359(a)(1)

Advertisements and License Number. Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and interview, the advertisement in front of the home does not include a license number, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/24/2023
Plan of Correction
1
2
3
4
By 2/24/23, licensee must add either the facility license number to the advertisement in front of the home or remove the advertisement. Licensee must send LPA picture confirming the license number was added to the advertisement or removed the advertisement.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Jason Jang
LICENSING EVALUATOR NAME:Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2023


LIC809 (FAS) - (06/04)
Page: 2 of 6