394500898-8-8-2023-53-CC-TDIP-CUHUZ4-20230808160054

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500898
Report Date: 08/08/2023
Date Signed: 08/08/2023 04:01:14 PM

Document Has Been Signed on 08/08/2023 04:01 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	MENDEZ, ELDA		FACILITY NUMBER:	394500898
ADMINISTRATOR:	ELDA MENDEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 321-6709
CITY:	MANTECA	STATE: CA	ZIP CODE:	95336
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	08/08/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Elda Mendez		TIME COMPLETED:	04:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 08/08/2023 at 2:00 PM, Licensing Program Analyst (LPA) Tiffanie Diep met with Applicant Elda Mendez for the purpose of conducting a change of location inspection. Applicant is requesting a change of location from previous facility (#394500188) to current location. LPA was accompanied by Applicant during the inspection. A fire clearance for current location was granted by Lathrop-Manteca Fire Department on 07/19/2023. Applicant's tentative operating hours are Monday through Friday from 5:00 AM to 5:00 PM. A health and safety inspection of the home’s interior and exterior was conducted. The one-story home has four bedrooms and two bathrooms. There is also a kitchen, laundry room, and day care area. LPA verified all knives and toxic and hazardous items were inaccessible to children. LPA observed cleaners stored underneath kitchen sink and inaccessible to children. Functioning dual smoke and carbon monoxide detectors were observed in the day care area. A 3A40BC fire extinguisher was observed by the kitchen and a first aid kit was observed in the bathroom. Applicant stated there is a weapon and pets in the home. LPA observed the weapon was stored according to Title 22 Regulations. Applicant has pets and stated they will maintain supervision to ensure children's safety. LPA observed a space heater in the home that was designed to look like a fireplace. Applicant stated the front panel does not get hot. LPA observed Applicant touch the front panel. Applicant stated they will not use the space heater and will maintain supervision to ensure children's safety. The outdoor play area was inspected and is surrounded by wooden and steel fences. LPA walked the perimeter of the outdoor play area during inspection and verified that the entire area is fenced in. LPA did not observe bodies of water on the premises. The off-limits areas in the home include all the bedrooms, master bathroom, kitchen, and laundry room. Applicant understands off-limits areas will remain inaccessible to children in care by baby gates and supervision. Applicant understands that if any structural changes are made to the home, Licensing must be notified prior to construction. Applicant also understands that Licensing must be notified prior to use of any off-limits area and an inspection must be completed by an LPA before children are allowed in the area. Continues on 809-C

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MENDEZ, ELDA	FACILITY NUMBER: 394500898
	VISIT DATE: 08/08/2023

NARRATIVE

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Continued from 809 (Page 2)

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of five days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

On 06/21/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders (RSOs) were found at the facility addresses. Under state law, some RSOs are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all RSOs against all Community Care Licensing Division (CCLD) facility addresses pursuant to information shared by California DOJ.

LPA discussed the mandated reporter training requirement with Applicant. Health and Safety Code section 1596.8662 requires all licensed child care providers, applicants, administrators, and employees of a licensed child care facility to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicant’s current Mandated Reporter Training certificate expires on 04/02/2024. Current pediatric CPR and first aid training was verified and expires on 03/25/2024. LPA discussed the requirement to renew CPR and first aid certifications every two years prior to expiration. Proof of enrollment for preventative health and safety training including nutrition and lead exposure was verified.

Incidental Medical Services (IMS) policy was discussed. For IMS information, see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MENDEZ, ELDA	FACILITY NUMBER: 394500898
	VISIT DATE: 08/08/2023

NARRATIVE

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Continued from 809-C (Page 3)

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 discussed the requirement to check and log infant napping every 15 minutes for infants under 24 months. LPA provided a copy of the Individual Sleeping Plan (LIC 9227) for infants under 12 months.

LPA reviewed with Applicant the Forms/Records To Keep In Your Family Child Care Home (LIC 311D), children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist (LIC 9280) was provided to Applicant. Applicant understands that records for children and staff, including a current children’s roster, are to be maintained according to Title 22 Regulations and accessible to Licensing for up to three years. Proof of required immunizations for Applicant was verified. Applicant understands that fire and disaster drills must be conducted and documented once every six months. Applicant understands that if an unusual incident occurs, a report shall be made to the Department by telephone, e-mail, or fax within 24 hours and the Unusual Incident/Injury Report - Family Child Care Home (LIC 624B) shall be submitted within seven days to remain in compliance. Applicant understands that licenses are not transferrable, and once licensed, the licensee must live in the home and be present for 80% of the operating hours.

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 platforms. 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 e-mail communication.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: MENDEZ, ELDA	FACILITY NUMBER: 394500898
	VISIT DATE: 08/08/2023

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Continued from 809-C (Page 4)

Applicant was encouraged to visit CCLD’s website at http://ccld.ca.gov/ for information regarding child care updates, forms, regulations, and legislation pertaining to Community Care Licensing. Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A provisional license for a large Family Child Care Home is granted effective today, August 8, 2023. The facility is approved to serve a capacity of 12 children (when there is an assistant present) with no more than 4 infants. Infants are children under the age of 2. Without an assistant present, Applicant must follow regulations for a small Family Child Care Home. Because Applicant rents/leases the home, proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification form (LIC 9151) that Applicant confirms was provided to the property owner/landlord. Applicant has not obtained a signed Property Owner/Landlord Consent Form (LIC 9149). Without this consent, Applicant understands that, once licensed, they can operate with a maximum capacity of 12 children. If property owner/landlord consent is obtained in the future, Applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25 to increase the capacity and provide care to 14 children.

The provisional license will expire on November 8, 2023. A regular license will be issued once the following is completed and submitted to LPA:

Preventative Health and Safety Training certificate

An exit interview was conducted and report was reviewed with the applicant, Elda Mendez.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023

LIC809 (FAS) - (06/04)

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