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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300780
Report Date: 04/27/2023
Date Signed: 04/27/2023 02:37:07 PM

Document Has Been Signed on 04/27/2023 02:37 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:DE HARO FAMILY CHILD CAREFACILITY NUMBER:
336300780
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/27/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Veronica De HaroTIME COMPLETED:
02:45 PM
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On 4/27/23, Licensing Program Analyst (LPA) Keely Messerschmidt and Licensing Program Manager (LPM) Carlos Martinez conducted a Pre-Licensing inspection with Applicant, Veronica De Haro to ensure the facility meets basic licensing requirements set forth by Title 22, California Code of Regulations and Health and Safety requirements. The applicant is requesting to provide care for a Small Family Childcare home (FCCH) for the capacity of 8 children, ages 0 to 10 years of age. Currently, there are 2 adults (applicant and Arturo De Haro) living in the home. LPA toured the home indoors and out to ensure it meets FCCH requirements. The applicant is requesting the days and hours of operation to be Monday through Friday 6:00 am to 5:00 pm.

The home is described as follows:

This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, dining room, laundry room, garage, and backyard. The home has central air/heating. All windows are free of cracks, bugs, and debris.



Indoor:
Main area: Childcare will be provided in bedroom #2, in the dining room and living Room. All unused electrical outlets have plastic covers, plugged in, and made inaccessible to children. The home does not have a fireplace. LPA observed age-appropriate toys, books and equipment for children to play with. Children will use the bathroom in the hallway. Children have access to the backyard.

Bathroom #1: Children will use bathroom in the hallway. Bathroom #1 was inspected, and the sink and toilet are in operable condition. Toilet and faucets are clean, safe and shower area free of hazards. LPA did not observe medication storage in the medicine cabinet or cleaning supplies/toxins in the cabinets.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Keely Messerschmidt
LICENSING EVALUATOR SIGNATURE: DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2023
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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: DE HARO FAMILY CHILD CARE
FACILITY NUMBER: 336300780
VISIT DATE: 04/27/2023
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Kitchen: The kitchen was clean, orderly, and free of hazardous items. The refrigerator, dishwasher, stove, and microwave were observed to be clean and operable. All lower cabinets in the kitchen have child locks. No medications are being stored in the cabinets. All sharp utensils, cutlery, cleaning supplies, plastic bags, and other sharp items were made inaccessible to children with magnetic child locks on cabinet doors and/or drawers. LPA also observed a working telephone.

Pets: one small dog in home
Napping equipment: LPA observed 6 cots to be used for napping equipment. Per the applicant, the children will nap on cots in the daycare area (bedroom #2) with adult supervision.
Electrical outlets: are all covered
The First Aid kit: is located in the closet besides the daycare area, in a locked closet, inaccessible to children. All required items, including thermometer, tweezers, bandages, tape, gauze, and antiseptic wipes were observed.
Weapons or Firearms: Per the applicant, there are no weapons or firearms on the premises and LPA did not observe any during time of inspection.
A smoke detector and a carbon monoxide detector: LPA observed all smoke detectors/carbon monoxide detectors were operable and on a signal system.
Fire extinguisher: There is a fully charged fire extinguisher (2A10BC) located in the kitchen, which met fire marshal standards.

Off-limit areas:
Bedrooms with door lock: Master bedroom #3, Bedroom #1 have safety doorknobs to make the room inaccessible to the children.
Bathroom #2 (Master Bathroom): The bathroom was toured and inspected.
Laundry room: The cleaning supplies, toxins and poisons are stored in the garage.
Garage: LPA inspected the garage. The garage is accessed through the Laundry room (safety doorknobs) and no childcare activities will be conducted there.

Outside: The backyard was observed to be completely fenced. There was no pool or other bodies of water observed by the LPA. There was also no thorn bushes, cactus, or other potential hazardous items observed in the outside area.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Keely Messerschmidt
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: DE HARO FAMILY CHILD CARE
FACILITY NUMBER: 336300780
VISIT DATE: 04/27/2023
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Documentation:
The applicant has current CPR, First Aid Training with the expiration dates of 3/2025, and Prevented Health and Safety Training completed 4/20/23. The applicant has fingerprint clearance, TB clearance and proof of being immunized against influenza, pertussis, and measles. The applicant has proof of Mandated Reporter Training dated 3/15/23. Per the applicant, meals and snacks will be provided for children and she will not be providing transportation.

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. According to the applicant, she will not provide IMS at this time. However, she will contact the RO if she enrolls any children with medical needs.

Applicant was reminded 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 discussed the safe sleep regulations with Applicant 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 Applicant 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.

LPA reviewed with Applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Keely Messerschmidt
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: DE HARO FAMILY CHILD CARE
FACILITY NUMBER: 336300780
VISIT DATE: 04/27/2023
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following items were also reviewed with the applicant during inspection:
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a mandated reporter and updating training every 2 years
- Personal rights of children in care, including no corporal punishment
- Responsibility to know the Title 22 Regulations for anyone providing care and supervision
- Capacity and Supervision requirements
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility phone numbers must always be on file with the licensing office
- Baby walkers, bouncy seats, exert-saucers and other similar items are prohibited
- Car seat law
- Smoking is prohibited in the facility while providing childcare or transporting children
- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of
30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also
be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.
- Applicant was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
-The Applicant can submit fingerprint transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations858@dss.ca.gov
- Access to forms & Title 22 Regulations for Family Child Care Homes obtained online at www.ccld.ca.gov
- The Duty Officer is available to answer questions Monday – Friday 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

LPA will submit application to LPM for approval for a small FCCH for a capacity of 8 children.
Exit interview conducted and report was reviewed with the Applicant Veronica De Haro.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Keely Messerschmidt
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
LIC809 (FAS) - (06/04)
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