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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629425
Report Date: 12/06/2023
Date Signed: 12/06/2023 10:20:52 AM

Document Has Been Signed on 12/06/2023 10:20 AM - 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ALVARADO MALDONADO, MARFELIA FAMILY CHILD CAREFACILITY NUMBER:
376629425
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
12/06/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Marfelia Alvarado MaldonadoTIME COMPLETED:
10:15 AM
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On December 6th, 2023, at 9:15 AM, Licensing Program Analyst (LPA), Jo Ann Legaspi conducted an unannounced capacity increase inspection. Licensee Marfelia Alvarado Maldonado was advised of the meeting’s purpose and granted LPA facility entry. Present in the home was the Licensee, one (1) helper and five (5) children. Licensee's adult son, Sebastian Aguilar, came to the facility to provide Spanish language translation services.

On 10/16/2023, Licensee submitted an application (LIC 279) requesting a capacity increase. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal on 10/26/2023 for fourteen (14) children.

This two (2) story, four (4) bedroom, three (3) bathroom house was toured and inspected. The following areas used for childcare are: the downstairs – living room, dining room and bathroom. The off-limit areas are the top floor. The stairs to the top floor are barricaded with child safety gates. Licensee accompanied LPA on a tour of the home, as shown on the updated facility sketch. Background criminal record clearances were verified and discussed. First Aid and CPR certifications expire in May 2024. Facility has a working 2A10BC fire extinguisher, smoke detector, carbon monoxide detector, and the first aid kit in place. The last safety drill was on 08/04/2023. There are no bodies of water on the premises. Per the Licensee, no firearms/ammunition are housed in the facility. The daycare schedule is weekdays 6 AM to 6 PM.

The Licensee provided proof of control of property. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the licensee confirms was provided to the property owner/landlord. The licensee obtained a signed Property Owner/Landlord Consent form (LIC 9149).

The Licensee was provided with the Ratio/Capacity Worksheet for a large family childcare home. The
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2023
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ALVARADO MALDONADO, MARFELIA FAMILY CHILD CARE
FACILITY NUMBER: 376629425
VISIT DATE: 12/06/2023
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Licensee recognizes that the total amount of children simultaneously in the home also includes children who reside in the home. The Licensee acknowledged that if no assistant provider is present at a Large Family Child Care Home, then the Licensee shall comply with the capacity requirements for a Small Family Child Care Home.

Licensees of family day care homes shall ensure that at least one staff member shall always be onsite when children are present at the facility and shall be present with the children when children are offsite from the facility for facility activities. The Licensee shall ensure at least one staff member has a current course completion card in pediatric first aid and pediatric CPR issued by the American Red Cross, the American Heart Association, or by a training program that has been approved by the Emergency Medical Services Authority. Prior to employment or initial presence in the childcare home, all employees subject to a criminal record review shall: obtain a California clearance or a criminal record exemption as required by law or Department regulations or request a transfer of a criminal record clearance. The Licensee shall not employ a staff member if they have not been immunized against tuberculosis influenza, pertussis, and measles. Each employee shall receive an influenza vaccination between August 1 and December 1 of each year. The employee may submit a yearly written declaration attesting that they have declined the influenza vaccination. This exemption applies only to the influenza vaccine. Documentation of immunizations is to be maintained in the staff’s facility personnel record. The Licensee shall provide each employee with a copy of the Notice of Employee Rights (LIC 9052 (4/88)) form furnished by the Department. Each employee shall be requested to sign and date the notice form acknowledging receipt. A copy of the signed notice form shall be retained in the employee's personnel record. If the employee refuses to sign the notice form, a dated notation to that effect shall be retained in the employee's personnel record.

The Licensee is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. Duty Line was provided: (619) 767-2248. Southern California Child Care Advocate (SCCCA) information was provided. The Licensee is already enrolled in this program’s email list through the CCLD website, thus receives updated regulation information. Advocate information was provided: (916) 654-1541 and childcareadvocatesprogram@dss.ca.gov

In the areas that were evaluated, no deficiencies were observed. Licensure for a capacity of fourteen (14) of children is approved today (12/06/2023). Licensee requests to the new license be mailed to them when available.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2023
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ALVARADO MALDONADO, MARFELIA FAMILY CHILD CARE
FACILITY NUMBER: 376629425
VISIT DATE: 12/06/2023
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Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Licensee Marfelia Alvarado Maldonado.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2023
LIC809 (FAS) - (06/04)
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