214005467-10-27-2022-05-CC-HLEG-CKLUGZ-20221027153511

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005467
Report Date: 10/27/2022
Date Signed: 10/27/2022 03:35:25 PM

Document Has Been Signed on 10/27/2022 03:35 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:	RAMIREZ, MARIA C. AND IAVARONE, LETICIA		FACILITY NUMBER:	214005467
ADMINISTRATOR:	RAMIREZ, MARIA C.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 747-8539
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	10/27/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Maria Ramirez		TIME COMPLETED:	03:50 PM

NARRATIVE

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On 10/27/2022, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the Maria Ramirez & Leticia Iavarone. facility. The LPA was granted entry by the Licensee, Maria Ramirez. The LPA explained the purpose of the visit to the licensee. Guardian, the department's system for conducting background checks, has confirmed that all the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The LPA observed the licensee and two assistants supervising four infants and four preschool children. Children's capacity and ratio requirements were observed to be in compliance,

Day-care Area(s): Living room, Play room, Bathroom and Backyard.

Off Limit Area(s): Kitchen, Three bedrooms, Garage and the Garden area in the back.. All off-limit area(s) are secured with a locked door or a safety gate. The licensee understands that off-limits areas may not be used for childcare during business hours.

The LPA and the licensee both performed careful inspections of the day-care facilities to look for any potential health and safety hazards. Toys and equipment that are suitable for children of the proper age range are provided at the day-care. The building has sufficient lighting and ventilation, and it is free of any defects or conditions that could put the children in its care in risk. The facility is equipped with a first aid kit that is completely loaded with everything that is required for the treatment of injuries. The day-care facility is equipped with a smoke detector, a carbon monoxide detector, and a fire extinguisher that is always ready for use. Every garbage can and power outlet has been covered. Products for cleaning and washing, detergents, and any other materials that could put children in danger are stored out of their reach. The LPA did not find any walkers, bouncers, or other comparable objects during its inspection.

There are reportedly no firearms or other weapons on the premises, as stated by the licensee. ***See Page 2 for continuation***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

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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Document Has Been Signed on 10/27/2022 03:35 PM - It Cannot Be Edited

Created By: Hanson Leong On 10/27/2022 at 02:20 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
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: RAMIREZ, MARIA C. AND IAVARONE, LETICIA	FACILITY NUMBER: 214005467
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/27/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

Administration of Child Day Care Licensing

(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, one of the staff members did not have their immunization record on file which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/04/2022
	Plan of Correction
1 2 3 4	LIcensee will submit a copy of her staff's immunization record to the department by the due date, 11/4/2022.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Daniel J Oquendo

LICENSING EVALUATOR NAME:

Hanson Leong

LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

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: RAMIREZ, MARIA C. AND IAVARONE, LETICIA	FACILITY NUMBER: 214005467
	VISIT DATE: 10/27/2022

NARRATIVE

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Continued, Page 2
The LPA found that the facility did not have any pools, spas, or other types of bodies of water of any kind.

The LPA observed that the facility had posted all the required forms, including the facility license, Notification of Parental Rights, Earthquake Preparedness Checklist, and Notification of Personal Rights. The licensee is aware that smoking is not permitted in a family childcare facility.

The LPA reviewed the records of five children. All required forms were in the children’s’ file.

The LPA reviewed the records of the licensee and her two assistants. All required forms were in the files of the licensee and one assistant. Review of the training records shows that the licensee and one assistant are current with their Pediatric First Aid / CPR certifications. One of the assistants didn't have a record of her immunization on file. The LPA informed the licensee that the facility will receive a Type B violation because her assistant's file didn't have an immunization record.

The LPA has informed the licensee that a Plan of Correction would be provided for all Type B violations. This Plan of Correction will enable the licensee to correct the violation.

According to the licensee, the facility satisfies the requirements by carrying out simulations of fire and earthquake drills every month, as well as by documenting their results.

The 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.

Incidental Medical Services (IMS) policy was discussed with the licensee. For IMS information, see Evaluator Manual Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm ***See Page 3 for continuation***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

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: RAMIREZ, MARIA C. AND IAVARONE, LETICIA	FACILITY NUMBER: 214005467
	VISIT DATE: 10/27/2022

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The LPA reminded the licensee as of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

The LPA encouraged the licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

The LPA discussed the safe sleep regulations and Child Care Licensing Safe Sleep with the licensee, webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. The LPA also informed the 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.

A copy of this report, the “Notice of Site Visit,” and their appeal rights were given to the licensee.

A “Notice of Site Visit” must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Licensee, Maria Ramirez

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

LIC809 (FAS) - (06/04)

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