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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620661
Report Date: 07/23/2021
Date Signed: 07/23/2021 12:38:00 PM

Document Has Been Signed on 07/23/2021 12:38 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:ALVARADO, MARIAFACILITY NUMBER:
393620661
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
07/23/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Maria AlvaradoTIME COMPLETED:
12:45 PM
NARRATIVE
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On July 23, 2021 Licensing Program Analyst (LPA), Fabiola Diaz met with licensee, Maria Alvarado, for the purpose of an increase of capacity inspection. Licensee applied to change from a Small Family Child Care Home to a Large Family Child Care Home. Upon entering the home, LPA observed 6 day care children present in the home, and licensee's adult daughter.

The one story home has a fenced front yard, 4 bedrooms, 2 bathrooms, living room, family room, dining room, kitchen, garage, laundry room, and fenced backyard. The off-limits areas in the home are garage, all bedrooms, and backyard. Licensee acknowledged that children may never enter the off-limit areas. Licensee acknowledged that if she would like to change an off-limits area to on-limits, she will inform LPA for inspection and approval prior to using the space. All adult residents have criminal record clearances.

During the inspection, LPA requested a tour of the facility. LPA and Licensee conducted a health and safety tour inside and out the home. Functioning smoke and carbon monoxide detectors and 2A10BC fire extinguisher were observed in the home. The Fire Safety Inspection Clearance has been cleared by Lathrop-Manteca FPD as of 6/14/2021. The fire place in the family room was barricaded meeting Title 22.

LPA observed that there were no hazardous items accessible to children inside the home and front yard. Licensee stated that she understands that any poisons must be kept under lock and key. LPA observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Toys appear to be safe. The backyard is fenced and gated. LPA discussed safety regulations of play equipment.



LIC 809 continues on LIC 809C...
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Fabiola Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2021
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: ALVARADO, MARIA
FACILITY NUMBER: 393620661
VISIT DATE: 07/23/2021
NARRATIVE
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On today's date LPA observed the above ground pool to have an additional fence installed on the side of the pool, which licensee stated was licensed and approved on a prior inspection. LPA observed the pool fencing to not surround the entire above ground pool. LPA observed the fencing to have a gap that varied in width, between the pool and the fence. LPA measured the largest gap to be 6.5 inches in width. LPA also observed a planter on the side of the pool, making the pool fence not meet the 5ft height. Children's and staff records, postings, and reporting requirements were discussed. LPA observed a complete children's roster and fire drill log. Licensee was encouraged to visit the department website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, self-assessment guides, regulations and legislation pertaining to family child care homes. Licensee was provided with the new Safe Sleep Regulations PIN. LPA provided PIN 21-18-CCP, with COVID-19 guidance.

Today 7/23/21, the facility was not approved for a Large Family Child Care License to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or above and 1 child at least age 6 with a maximum of 3 infants. Without assistant, the ratios revert to those for small family childcare home. LPA will return to the facility at a later date to conduct a case management inspection to inspect the backyard and the above ground pool. Once the backyard and above ground pool meets Title 22 regulations, the home may be granted a Large Family Child Care License when all other requirements are met. Licensee made the backyard off-limits as of today and provided with an update of the facility sketch. Licensee stated that children in care have not been using the backyard since the pool has been installed. Licensee stated that the children in care will continue to use the front yard at play time and not the backyard while the pool is being changed to meet Title 22 regulations. Licensee stated the children in care will be supervised at all times while using the front yard.
An exit interview was conducted. The following Title 22 Deficiency is being cited on the subsequent 809-D page. Upon receipt of Type A citations, licensee shall post and provide copies of the LIC 809-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Licensee must also keep the signed LIC 9224, acknowledging receipt of LIC 809-D in each child's file. Appeal Rights and Notice of Site Visit were provided. LPA observed the Notice of Site Visit to be posted: it must remain posted for 30 days.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Fabiola Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/23/2021 12:38 PM - It Cannot Be Edited


Created By: Fabiola Diaz On 07/23/2021 at 11:45 AM
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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: ALVARADO, MARIA
FACILITY NUMBER: 393620661

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/24/2021
Section Cited
CCR
102417(g)(5)(A)

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102417 Operation of a Family Child Care Home A) Fences shall be at least five feet high... fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code...Pool covers shall...completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use. This requirement was not met as evidenced by:
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Licensee made the backyard off-limits as of today and provided with an update of the facility sketch. Licensee stated that the children will not use the backyard while the pool is being changed to meet Title 22 regulations.
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Based on observation and interview, licensee did not ensure the fence to surround the entire above ground pool. LPA observed the pool fencing to have a 6.5 inch gap, and LPA observed a planter on the side of the pool, making the fencing not meet the 5 ft height.
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Licensee stated the children will be supervised at all times while using the front yard. Licensee stated that the current pool fencing was licensed and approved on a prior inspection in 2020. Licensee stated she will continue to stay in communication with LPA and management to continue to work on the pool to meet Title 22.

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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:Jeanne Smith
LICENSING EVALUATOR NAME:Fabiola Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 07/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/23/2021


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