073409060-2-9-2024-02-CC-SBLE-D2ASD6-20240209124636

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409060
Report Date: 02/09/2024
Date Signed: 02/09/2024 12:46:46 PM

Document Has Been Signed on 02/09/2024 12:46 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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	LOPEZ, ROSARIO		FACILITY NUMBER:	073409060
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 5	CENSUS: 0	DATE:	02/09/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Rosario Lopez		TIME COMPLETED:	01:00 PM

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On 02/09/2024 at 11:15 am, Licensing Program Analyst (LPA) Sikia Blue arrived at the home for an unannounced Required Random Inspection. LPA met with Rosario Lopez to explain the purpose of today’s visit. Present in the home was licensee, adult daughter and minor grandchild. Today census is zero children in care with five children enrolled. The facility operating hours are Monday-Friday 8:00am-5:00pm. Licensee provides meals(milk) and water for all children in care. LPA observed ample supply of 2% milk and whole milk.

LPA toured the areas of the home used to provide care for children, to complete a health and safety inspection. The home is neat and clean with heating and ventilation for the safety and comfort of children in care. This is a two story 4 bedrooms and 3 bathrooms home which consists of 4 bedrooms and 3 bathrooms, living room, dining room, kitchen, laundry area fenced backyard for outdoor play area, and garage. The ON LIMIT areas include family room and backyard OFF LIMIT areas include entire second floor 4 bedrooms and 2 bathrooms, kitchen, garage, and dining room. Off limit areas are inaccessible to children in care by closed and/or locked doors, visual supervision and a safety gate. The ISOLATION area will be the couch area in the family room away from other children in care. The backyard is used for outdoor play and LPA observed that all the toys were neat and clean and equipment safe for children to play. The parent board is located behind the door on the wall and has all the required documents at this time.

LPA observed an ample supply of age appropriate toys, equipment and furniture that appear to be safe and in good condition. LPA DID NOT observe any bodies of water. LPA DID NOT observe any hazardous materials, toxins or medications accessible to children today. The home is equipped with a smoke detector, carbon monoxide detector, working telephone, and fully stocked first aid kit. The fire extinguisher is a 3A-40-BC and 1A-10-BC fully charged in the green area. The licensee's CPR/First Aid certificates are current, with an expiration date of 1/26. The licensee completed the required mandated reporter training, and it will expire on 02/26. The licensee stated that there are no firearms in the home.

REPORT CONTINUED on PAGE 2...

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2024

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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LOPEZ, ROSARIO	FACILITY NUMBER: 073409060
	VISIT DATE: 02/09/2024

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At 12:20pm LPA asked licensee if fire/earthquake drill have been conducted and the form filled out and the last drill was conducted on 08/2023. Licensee confirmed that the emergency disaster plan is up to date. LPA reviewed 3 children’s files and found them to be complete with all required documents.

At 11:45pm LPA Reviewed one personnel file and it is complete. The licensee was reminded that walkers, baby bouncers and drop down cribs are not allowed in day care facilities. LPA observed the Facility roaster and it has all children and is complete. LPA also observed the provider has a sleep plan for infant in care. The provider was informed of the importance of continuously making sure the sleep plan is filled out properly and accurately. LPA explained the importance of the roaster being current and up to date at all times for the facility records and needs to be kept for 3 years.

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-andresources/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.

REPORT CONTINUED on PAGE 3...

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2024

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 CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LOPEZ, ROSARIO	FACILITY NUMBER: 073409060
	VISIT DATE: 02/09/2024

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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/.

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.

Based on observation, documents, and interviews, no deficiencies will be cited today

Exit interview conducted at 3:45pm, Licensee confirmed that there are no Registered Sex Offenders living in the facility. Notice of site visit was given and must remain posted for 30 days. Report was reviewed and given to the licensee, Rosario Lopez. Appeal rights were provided.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2024

LIC809 (FAS) - (06/04)

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