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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500489
Report Date: 02/14/2023
Date Signed: 02/14/2023 03:18:22 PM

Document Has Been Signed on 02/14/2023 03:18 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:ACEVEDO, FLORFACILITY NUMBER:
394500489
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
02/14/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Flor ACevedo TIME COMPLETED:
03:41 PM
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On February 14, 2023, Licensing Program Analyst (LPA) Stacey Williams met with Licensee Flor Acevedo for the purpose an Increase of Capacity inspection. LPA observed five children supervised by the Licensee. LPA and Licensee toured the two story 3-bedroom home. Off-limit areas include all bedrooms, laundry room, front closets and the garage. Licensee acknowledged that children may never enter these off-limit areas. Licensee has requested a capacity increase to 14 children. Fire clearance has been approved by the Stockton Fire Prevention Department on 1/30/23. Licensee stated there are no new residents in the home since licensure. All Adult residents have criminal record clearances. The Department received the Fire Safety Inspection Clearance, and home has been cleared for up to 14 children. Large family childcare home capacity limitations were reviewed during today's inspection.

LPA observed cleaning supplies properly stored out of reach of children. LPA observed medications out of reach of children. Licensee stated there are no weapons in the home. Fire extinguisher (2A10BC), smoke detector, and carbon monoxide meet regulation. Toys appear to be clean and safe. The backyard is fenced, there is a fenced area designated for Licensee’s dog. Licensee stated the dog remains inaccessible to children during childcare hours by staying in off limit area or in the fenced area in the backyard. Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.

LPA observed a current CPR/First Aid certificate Exp 10/2024. LPA reviewed a child's file during today's inspection. LPA observed the file contained emergency contact information and signed Notifications of Parents’ Rights. LPAs discussed changes in sleep regulations and advised licensee to visit the licensing website at http://www.ccld.ca.gov for current forms, laws, regulations and legislation. LPAs provided updated information for children's files to the licensee during today's inspection.

Report Continues on 809-C
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2023
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: ACEVEDO, FLOR
FACILITY NUMBER: 394500489
VISIT DATE: 02/14/2023
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All adults subject to criminal background review have obtained criminal record clearance. 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs also informed 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. LPAs discussed the requirement to check and log infant napping every 15 minutes, for infants under 24 months and under 24 months. LPAs provided a copy of LIC 9227 Individual Sleeping Plan, for infants under 12 months.

This provider is not currently providing Incidental Medical Services (IMS) services to children in care. 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

Effective today's date, 2/14/23, Licensee is approved for the capacity increase to serve up to either 14 children, one (1) of which must be enrolled in kindergarten and at least one (1) 6 years of age and no more than three (3) may be infants; or 12 children, four (4) of which may be infants. Infants are children under the age of 2.

In the areas that were evaluated, no deficiencies were observed at the time of the inspection.

LPA reviewed report with the Licensee, Flor Acevedo and provided copies of the report along with Appeal Rights. A notice of site visit was provided and posted by LPA Williams and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023
LIC809 (FAS) - (06/04)
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