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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005398
Report Date: 10/20/2021
Date Signed: 10/20/2021 04:10:25 PM

Document Has Been Signed on 10/20/2021 04:10 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:ALVAREZ, ALCIRAFACILITY NUMBER:
214005398
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
10/20/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Alcira AlvarezTIME COMPLETED:
04:20 PM
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On 10/20/21 at 2:00 pm., Licensing Program Analyst (LPA), Farhan Bashir-Tariq arrived at the facility above to conduct an unannounced case management inspection. Purpose of inspection was explained and was to inspect the home for capacity increase. There were seven children (3 infants, 3 preK, 1 school age) present today with Licensee. Licensee is operating within the capacity and is following staff child ratio on this day. LPA verified the background check clearance of the adults working or living in the home. Licensee rents the home, which is a two bed room and one and a half -bathroom apartment. Licensee lives with husband and a child. The hours of operation are: M-F, 7:30 AM – 5:30PM. Licensee provides breakfast, lunch and two snacks. Licensee is part of food program. Day Care areas: Living room, Balcony adjacent to living room, Full bathroom, Half bathroom, and Bedroom #2. Off Limit areas: Bedroom #1, Kitchen and Closet in hallway.

LPA and Licensee inspected the entire day care area for Health and Safety Hazards. All off limit areas are properly barricaded and made inaccessible to the children in care. Licensee states that there is no pool, spa or any other body of water in the home. Licensee states, there are no weapons or firearms in the home. Licensee states, there is small bunny in the home, which is kept in a cage in bedroom #2. Cabinets in the bathroom has child protective locks. The house is in good repair and free of hazards with proper temperature and ventilation. There are multiple carbon monoxide detectors and smoke detectors available in the home. LPA tested one of the detectors. A fully charged fire extinguisher and a working telephone was available in the home. First Aid kit and emergency kits were available inside home and for field trips. LPA observed that there were plenty of age appropriate toys, books, puzzles, arts and other learning material available in the home. Discipline policy is redirection and communication. Kitchen is off limit and will not be used for children in care. Access to the kitchen has been blocked off with a baby. Stove knob covers have also been stored. There is a small balcony area adjacent to living room, which will also be used for children. Balcony is blocked off all around. Access to balcony is through living room sliding door. Licensee has a CPR and First Aid training card valid until 12/2022. LPA reminded the Licensee to conduct the fire or emergency drills at least once every six months and drills must be logged. Licensee has a log for each drill being conducted. Per licensee’s log, last drill was conducted in June 2021.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2021
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: ALVAREZ, ALCIRA
FACILITY NUMBER: 214005398
VISIT DATE: 10/20/2021
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Licensee’s mother will be her helper upon approval and getting a large license. Mother is already finger printed and have a valid first aid and CPR card expiring in 12/2022. Mandatory child abuse training certificate was observed for Licensee taken on 2/10/2021. This certificate is valid for two years. Licensee also provided safe sleep log for infants. Licensee was documenting times following the correct procedure as required by Licensing. Licensee was observed to be wearing mask around children. COVID 19 poster, masks, cleaning wipes and sanitizers were available in the home.

Capacity restrictions for large family child care home were discussed with Licensee per fire clearance. Licensee will be recommended for approval for a large license with the capacity of 10 children in total following the fire clearance approval. Licensee shall not care for more than 10 children at any given time. These 10 children can include maximum of 4 infants and the rest six can be in any combination of preschool or school age children only when there is a helper present. If there is no helper available, then capacity limits of a small family child care home will apply. Licensee’s daughter also holds a license for small family child care home at the same address in apartment #47. Children from both programs shall not be co-mingled at all at any given time. Children and their files for both programs shall be stored and kept in the respective program.

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

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.


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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: ALVAREZ, ALCIRA
FACILITY NUMBER: 214005398
VISIT DATE: 10/20/2021
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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.

LPA reminded Licensee , as of January 1, 2018, all staff is required to complete Mandated Child Abuse Reporter Training (AB1207) every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Facility can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

Large Family Child Care Home License will be recommended for approval and will be effective as of today, 10/20/21 with a total capacity of 10 children following the ratio described on Page 2 of this report and per fire safety clearance.

An exit interview was conducted. This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit. Licensee was advised for any additional questions to call Office, M-F, 8AM-5PM at 650-266-8800. For Rules and Regulations, visit the Website: www.cdss.ca.gov


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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
LIC809 (FAS) - (06/04)
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