073407702-4-29-2024-02-CC-ILOA-D4SVQ7-20240429163751

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073407702
Report Date: 04/29/2024
Date Signed: 04/29/2024 04:38:05 PM

Document Has Been Signed on 04/29/2024 04:38 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:	PACHECO, VALERIA		FACILITY NUMBER:	073407702
ADMINISTRATOR:	PACHECO, VALERIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 504-2114
CITY:	SAN PABLO	STATE: CA	ZIP CODE:	94806
CAPACITY:	14	CENSUS: 9	DATE:	04/29/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:	Valeria Pacheco		TIME COMPLETED:	04:45 PM

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On April 29, 2024 at 12:25pm, Licensing Program Analyst (LPA) Indira Loza arrived at the facility for an unannounced Random/Annual inspection. LPA met with Licensee Valeria Pacheco. The applicant lives in the home with husband Alfredo Plaza. Present during today's inspection were 6 preschool age children, 3 infants, and the Licensee's Assistant Gricelda Zarate. All adults have been fingerprinted and have a cleared background check. The licensee operates Monday - Friday 7am - 5:30pm. LPA verified the applicant's phone number and email on record are correct.

LPA toured the home with the applicant, to conduct a health and safety inspection. LPA observed that the home is neat and clean with heating and ventilation for the safety and comfort of children. The home is a single family home consisting of a three (3) bedrooms, two (2) bathrooms, a fully fenced in front yard, walkway on both side of the house, backyard, a garage, and storage room in the backyard.

The Off Limit Areas - The master bedroom at the end of the hall, master bathroom, kitchen (is only used as a walkway for the children to go inside the home), storage room in the backyard, the front yard, and garage. The off limits areas are made inaccessible by gate, closed and/or locked doors and visual supervision.

The On Limit Areas are the living room, both bedroom to the right of the hallway (nap rooms), bathroom in the hallway, and backyard.

Isolation Area - on the bench in the living room, next to the parent board.

Inside the home the LPA observed an ample supply of age appropriate toys, activities and equipment for children, which appeared to be safe and in good condition. LPA did not observe any medication, bodies of water, or poisons accessible to children during the inspection today. Per licensee there are no firearms in the home. The home is equipped with a fully charged 2A10BC fire extinguisher. All adults working with the children have a current CPR first aid certificate, which expires 2/2026. The licensee provides all meals to the children in care.

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SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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: PACHECO, VALERIA	FACILITY NUMBER: 073407702
	VISIT DATE: 04/29/2024

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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.

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.

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 [or facility representative] 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.

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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; 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.

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SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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: PACHECO, VALERIA	FACILITY NUMBER: 073407702
	VISIT DATE: 04/29/2024

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During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There were deficiencies cited during to day's visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Valeria Pacheco.

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SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira Loza	TELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

LIC809 (FAS) - (06/04)

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