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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004475
Report Date: 05/03/2024
Date Signed: 05/03/2024 04:30:49 PM

Document Has Been Signed on 05/03/2024 04:30 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CATRAL, MERCEDES B.FACILITY NUMBER:
414004475
ADMINISTRATOR/
DIRECTOR:		CATRAL, MERCEDES B.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 619-7457
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 8DATE:
05/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Martha Zamantha LavaresTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On May 3, 2024, @ approx. 1:55 pm, Licensing Program Analyst (LPA) Maria Olguin-Leon met with helper, Martha Zamantha Lavares (licensee’s daughter) for an unannounced annual inspection. The purpose of the inspection was explained. Per daughter, Licensee out of the country. Present today was Licensee daughter, two adults and 8 children (2 infants & 6 preschoolers). Facility is operating within capacity and ratio requirements on this day. At approximately 2:10pm, LPA observed an adult with no criminal background clearance carrying a child. LPA cited a type A deficiency. Hours of operation are Monday– Friday, 7:30 am to 5:00pm.

LPA and helper toured the home for health and safety hazards. Licensee rents this one story, three-bedroom, one bathroom home. The DAY CARE AREAS: Living room, dining room, bedroom #1, bathroom and backyard. The OFF-LIMIT AREAS are bedrooms #2 & #3, kitchen, and garage. Off limit areas are properly barricaded with child safety gates and/or child safety locked doorknobs. Kitchen entrance from hallway is barricaded with a child proof gate. All cabinets are properly secured with child proof latches. Home is well light and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. Fireplace is properly barricaded with a toy storage unit. There are plenty of age-appropriate toys, books, child size furnishings, learning material, and sleeping mats. Backyard has plenty of age-appropriate play toys, swing set, playhouse and is surrounded by a 5 ft fence. Backyard patio area is equipped cement patio covered with outdoor rugs. Yard is equipped with grass to cushion falls. There are no spas, pools, or other bodies of water.

Home is equipped with a working carbon monoxide and smoke detector, and a fully charged fire extinguisher which located in hallway. Isolation area for ill children will be in dining room away from other children. First aid kit is fully stocked with supplies. Home is equipped with a landline and Licensee uses a cell phone on the premises. Per helper, there are no weapons or firearms in the home. Parents provide sheets for sleeping cots/play pens and are sent home weekly for washing.

Cont. page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CATRAL, MERCEDES B.
FACILITY NUMBER: 414004475
VISIT DATE: 05/03/2024
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LPA reviewed 6 children’s records and 2 staff records. LPA reminded Licensee to keep a personnel record for all employees, technical violation was issued. Licensee Mandated Reporter training expires 04/2025. Licensee’s CPR/First Aid is current and will expire on 08/2024. Licensee provides breakfast, lunch, and snacks to children in care. LPA reminded licensee that all bottles and food brought from home must be properly labelled with child’s name. Children’s roster was reviewed. All required postings are posted and include Childcare License, Notification of Parent’s Rights (PUB379), and Emergency Disaster Plan (LIC610A). Last emergency drill was conducted on 03/01/2024 and is properly documented. Per helper, Licensee carries liability insurance via DCI.

Licensee was reminded that all adults 18 and over living or working in the home, 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 5 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.

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)/ (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/.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee 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 against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee.

Cont. page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CATRAL, MERCEDES B.
FACILITY NUMBER: 414004475
VISIT DATE: 05/03/2024
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As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com

LPA discussed the safe sleep regulations with Licensee 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 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. LPA discussed sleeping logs with Licensee, technical violation was issued.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.


Licensee was informed of the MyChildCarePlan.org website; 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.

LPA Olguin-Leon informed helper Martha Zamantha Lavares that this report dated 05/03/2024 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Olguin-Leon) informed the helper Martha Zamantha Lavares to provide a copy of this licensing report dated 05/03/2024 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Cont. page 4....
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CATRAL, MERCEDES B.
FACILITY NUMBER: 414004475
VISIT DATE: 05/03/2024
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During the exit interview, the helper Martha Zamantha Lavares, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the helper, Martha Zamantha Lavares.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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Document Has Been Signed on 05/03/2024 04:30 PM - It Cannot Be Edited


Created By: Maria Olguin-Leon On 05/03/2024 at 04:03 PM
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
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CATRAL, MERCEDES B.
FACILITY NUMBER: 414004475

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Request Denied
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above in one adult living in the home was observed carrying a child and does not have a criminal background clearance, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 05/06/2024
Plan of Correction
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Adult living in home will have criminal background clearance done today and will not work with children until clearance has been received.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Marie Rodriguez
LICENSING EVALUATOR NAME:Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2024


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