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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073402539
Report Date: 08/23/2022
Date Signed: 08/23/2022 02:02:56 PM

Document Has Been Signed on 08/23/2022 02:02 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:CATANIA, MARIAFACILITY NUMBER:
073402539
ADMINISTRATOR:CATANIA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 934-2589
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 9DATE:
08/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jazmin MartinezTIME COMPLETED:
02:10 PM
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On 8//23/2022 at 10:00am, Licensing Program Analyst (LPA) Catherine Fernandes met with assistant Jazmin Martinez for an Unannounced Required Annual Inspection. The Licensee was out of town and not available for the inspection. Present during the inspection three infants, six preschoolers in care and an additional finger print cleared staff member. Residing in the home is only the Licensee. Licensee’s home was toured for a health and safety inspection. The facility operates 7:00am – 5:30pm, Monday - Friday.

The home is a single-story house that consists of two bedrooms and two bathrooms. The entrance to the day is the front door. The inside and outside of the home were observed to be neat, clean with age appropriate materials and toys for the children. All toxins, medications, and hazardous materials were observed to be in inaccessible areas. During today’s inspection, LPA observed the following precautions, there is a gate that blocks two steps that lead to the main area of the day care. Martinez has stated that there are no firearms and no pets in the home.


ON LIMITS AREA: Living Room, Dining Area, the family room (main day care area), the bathroom, and the enclosed backyard.
OFF LIMITS AREA: both bedrooms the bathroom in the bedroom, the right side of the yard when facing the home, the shed in the backyard, the office, the converted garage and the laundry room, which will be inaccessible by closed and/or locked doors or visual supervision.
ISOLATION AREA: Living Room
The home has a fully charged 4A60BC fire extinguisher located under the kitchen sink, a working smoke detector and carbon monoxide detector in the main area of the day care, and a working telephone. All required forms are now posted and visible for public view in the childcare room. The home conducts and documents fire and disaster drills twice a year with the last one conducted on 8/23/2022. The home has CPR and First Aid certificates that are current and expires on 3/2024. The home was reminded of the responsibility as a mandated reporter and will provide current proof of the required training. LPA did not observe any bodies of water in or around the home.
REPORT CONTINUES ON 809C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 08/23/2022 02:02 PM - It Cannot Be Edited


Created By: Catherine Fernandes On 08/23/2022 at 12:17 PM
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CATANIA, MARIA
FACILITY NUMBER: 073402539

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations and interview, the home did not comply with the section cited above an off-limit area of the home has been used, which poses an immediate safety risk to persons in care.
POC Due Date: 08/23/2022
Plan of Correction
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The area needs to inspected by CCL and the fire department prior to being used. LPA Fernandes inspected the converted garage however the licensee will contact the fire department and inform the LPA of the appointment date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Mayla Mendoza
LICENSING EVALUATOR NAME:Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2022


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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: CATANIA, MARIA
FACILITY NUMBER: 073402539
VISIT DATE: 08/23/2022
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LPA reviewed 10 children’s files, 3 staff files and obtained a copy of the facility roster.

The following was observed during today’s inspection:
- At 10:05AM, LPA Fernandes was told that Licensee Maria Catania was out on an emergency trip for a week and will be back on 8/26/22. No prior notice was provided to licensing.
- At 10:13AM, LPA observed the off limit garage had been converted to a day area without out proper clearance or notice from Licensing and the Fire Department.
- At 11:36AM, During file reviews LPA observed no current mandated reporter training.

Licensee was reminded that California Law requires Licensee 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 624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed staff that all forms can be downloaded at www.ccld.ca.gov. Staff was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting http://www.mandatedreporterca.com. Staff was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Children’s Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. The Staff is reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

Incidental 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. 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.
No IMS is being provided at this time.

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.
REPORT CONTINUES ON 809C.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
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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: CATANIA, MARIA
FACILITY NUMBER: 073402539
VISIT DATE: 08/23/2022
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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.

LPA discussed the safe sleep regulations with staff 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 staff 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.
For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgment form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.

Please provide the following copy to CCL for facility file:
-LIC 610A Emergency disaster form

Exit interview conducted Report and Appeal Rights provided to the facility representative Jazmin Martinez. A notice of site visit was given and must remain posted for 30 days.

See LIC 809-D for citation.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022
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