015700326-10-3-2024-52-CC-EWOS-D9PULT-20241003154117

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700326
Report Date: 10/03/2024
Date Signed: 10/03/2024 03:45:10 PM

Document Has Been Signed on 10/03/2024 03:45 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	ALANIZ, GABRIELA & ROMERO CAMPOS, JORGE		FACILITY NUMBER:	015700326
ADMINISTRATOR:	ALANIZ, GABRIELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 798-2953
CITY:	SAN LORENZO	STATE: CA	ZIP CODE:	94580
CAPACITY:	14	CENSUS: 11	DATE:	10/03/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:40 AM
MET WITH:	Gabriela Alaniz & Jorge Romero Campos		TIME COMPLETED:	04:00 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 October 3, 2024, at 1:40 PM, Licensing Program Analyst (LPA) Elimika Woods met with licensee's Gabriela Alaniz & Jorge Romero Campos for an Unannounced Annual/Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee's. There were 11 children present during today’s inspection, four infants and seven preschool age children. LPA verified the annual fees are current in the LIS system. The licensee's stated that the facility operates from Monday to Friday 6:00 AM to 6:00 PM. The off-limits of the home will be made inaccessible by closed and/or locked doors and visual supervision. There's a gate at the kitchen and front door entrance to prevent children's access to the outside area and kitchen stove. LPA checked the cabinets in the on limit areas which includes the bathroom, bedroom, living room and any other cabinets or drawers accessible to children in care and did not observe any hazardous materials or toxins accessible to children during today’s inspection. LPA toured the facility inside and out to conduct a Health and Safety inspection. This single-story home consists of three bedrooms, two baths, a living and dining room, kitchen, backyard, and detached one car garage. This home was clean and orderly, with (centralized) heating and ventilation for the safety and comfort. At 2:00 PM, LPA inspected the backyard area to make sure that there are no pools, hot tubs or any other bodies of water present that violates the childcare licensing laws and there were none, during today's inspection. The OFF LIMIT AREAS is the Bedroom one and Bedroom two, kitchen, storage shed, and the garage. The ON LIMIT AREAS are the living room, hallway bathroom, bedroom three, and the backyard for play area. LPA tested the dual smoke and carbon monoxide detector in the living room and found it to be functioning properly. The facility has a fully charged 2A10BC fire extinguisher which meets standards established by the State Fire Marshal in the kitchen. The licensee also has a first aid kit that she keeps at the front door entrance closet. The Isolation area of the home will be a section of the living room, away from other children in care. See 809-C for continuance.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: ALANIZ, GABRIELA & ROMERO CAMPOS, JORGE	FACILITY NUMBER: 015700326
	VISIT DATE: 10/03/2024

NARRATIVE

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LPA asked the licensee's do they transport children and the licensee's stated that they do not transport children. Per licensee's there are no weapons of any kind in the home. All required forms are posted and visible for public review.

At 2:20 PM, LPA requested and reviewed the files of four (4) children in care. All children’s files contain Immunization, Identification & Emergency Information, Parent's Rights, and Medical Consent forms. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 07/03/2024. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires on 03/2026. The licensee's have completed mandated reporter training on 03/20/2024. During the record review LPA Woods checked the Health Records of the licensee's, and children and found that the licensee's are following the immunization laws which pertain to all childcare providers.

LPA inspected the backyard play area to make sure it was safe and secure for children around 2:45 PM. The yard was fully fenced with no opening or missing boards on the gate. The backyard is free from defects or dangerous conditions. During today's inspection, there are no play structures which are required to be anchored. There are ample age-appropriate toys that appear to be safe and in good condition. There's a shed with a lock to prevent children access to equipment in the backyard. There is a fully enclosed/netted trampoline with a fastened closure. LPA reminded the licensee's that use of the trampoline requires direct adult supervision at all times.

Effective August 1, 2003, California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee's was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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/.

See 809-C for continuance.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: ALANIZ, GABRIELA & ROMERO CAMPOS, JORGE	FACILITY NUMBER: 015700326
	VISIT DATE: 10/03/2024

NARRATIVE

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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-andresources/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 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.

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.

The 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, the LICENSEE's Gabriela Alaniz & Jorge Romero Campos, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There are no deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee's Gabriela Alaniz & Jorge Romero Campos.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Elimika Woods	TELEPHONE: (510) 622-2550
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

LIC809 (FAS) - (06/04)

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