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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004565
Report Date: 05/23/2022
Date Signed: 05/23/2022 03:41:33 PM

Document Has Been Signed on 05/23/2022 03:41 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:ALMANZA, MARIA S.FACILITY NUMBER:
384004565
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/23/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Maria AlmanzaTIME COMPLETED:
03:55 PM
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On 5/23/2022 at 1:10PM., Licensing Program Analyst (LPA), Luis J. Gomez met with Applicant, Maria Almanza. Purpose of inspection was explained and was for an announced, prelicensing inspection. Present was the applicant and no children. Applicant's home is a three bedroom, two bathroom, one level unit. Control of property has been submitted to the Department. Days and hours of operations are: Monday- Friday, 7:00 AM., to 6:00 PM. Day-care Areas are: Living Room (Playroom), Kitchen and Bathroom #1. Off-limit Areas are: Bedroom #1, Bedroom #2, Bedroom #3 and Bathroom #2. LPA inspected entire home with applicant for health and safety hazards.

At 1:15PM., the following was observed: Home was clean, orderly and equipped with age-appropriate toys, books and art supplies. Materials and furniture inspected were in good repair. On-limit areas were completely carpeted. Playroom had child sized tables and chairs for food services and activities. For napping services, stackable cots were stored in the hallway closet. LPA observed fireplace in playroom had been barricaded. Fixtures tested in bathroom #1, were in operating condition. Bathroom #1 was maintained clean with supplies for child hand-washing. Safety lock had been installed on the accessible lower cabinets. Home was the proper temperature, with ventilation with sufficient lighting. Accessible electrical outlets had been covered. Bedrooms were made inaccessible with use of child safety gate. Home had a functioning cell phone, smoke/ carbon monoxide detector combo and fully changed fire extinguisher (3A:40:BC). Per applicant, isolation of an ill child will be in the Living Room. Detergents, cleaning compounds and other items which could pose a danger had been stored inaccessible to children. Per licensee, home does not have any no guns or weapons. Home does not have pools, fishponds, jacuzzi or any other bodies of water on the premises. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2022
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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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: ALMANZA, MARIA S.
FACILITY NUMBER: 384004565
VISIT DATE: 05/23/2022
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(PAGE 2)

At 1:35PM., LPA reviewed the required forms. LPA and applicant reviewed the LIC311D, Records to Keep in Your Family Child Care Home, Children’s Forms/ Records, Facility Forms, and Information to be Posted.

Applicant's Cardiopulmonary Resuscitation / First Aid certification was current, expiring on 1/16/2024. Applicant’s Mandated Reporter Certification (AB1207) was current, expiring 1/22/2024. Per applicant, she is planning to provide daily snack and meals.

Applicant was informed that the Department must be notified prior to the use of designated off-limits areas. LPA and the applicant discussed licensing regulations and the capacity requirements. Any children under 10 years of age will be counted in the capacity. Applicant was advised that all food containers brought from home must be properly stored and labelled. Applicant understands the required emergency disaster drills are to be conducted and documented every six months. Applicant understands that the use baby walkers, bouncers, jumpers and similar items are not to be used for children in care. Smoking is prohibited inside a Family Childcare Home.

Applicant was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility, unless he or she has been immunized for influenza, pertussis and measles or qualifies for an exemption pursuant to Health and Safety Code 1596.7995 and 1597.662.

Applicant was informed that all adults 18 years and over living or working in the home, including employee and volunteers, must obtain criminal 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 licensee and discussed Child Care Licensing Safe Sleep Web page at:https://www.cdss.ca.gov/inforesource/child-care-licesning/public-information-and-resources/safe-sleep as an additional resource. LPA informed licensee of the importance of checking for recalled infant devices on United States consumer Product Safety Commission (CPSC) website at http://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. (REFER TO 809C, FOR CONT.)
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2022
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: ALMANZA, MARIA S.
FACILITY NUMBER: 384004565
VISIT DATE: 05/23/2022
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(PAGE 3)
Incidental Medical Services (IMS) 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 Americans with Disabilities Act (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: www.ada.gov/childqanda.htm.

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 communication platform.

To receive important licensed- related information to licensed facilities, visit the CCLD important information website at https://www.cdss.ca.gov/infosource/community-care-licensing/subscribe and select the child care option to receive email communication.

During today's inspection, applicant submitted the following documents: LIC9182

Prior to recommendation for licensure, applicant must complete the following:


-Post all required postings in visible location in the facility
-Receive criminal record clearance for all adults in the home
-Installed safety latch on playroom windows (3)
-Installed cover on accessible heater vents (2)

Exit interview was conducted with applicant, Maria Almanza and copy of this report was provided.

This report will be kept in the facility file and made available for public review upon request. Desk Duty is available Monday through Friday between 8AM - 5PM at (650) 266 -8800.

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2022
LIC809 (FAS) - (06/04)
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