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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004727
Report Date: 07/28/2021
Date Signed: 07/28/2021 11:49:15 AM

Document Has Been Signed on 07/28/2021 11:49 AM - 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:FRETES, KAREN P.FACILITY NUMBER:
414004727
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
07/28/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Karen FretesTIME COMPLETED:
12:00 PM
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On July 28, 2021, at 10:15 am, Licensing Program Analyst (LPA) Van met with the Licensee, Karen Fretes, for a case management inspection. The purpose of the inspection was explained and granted entry to the home by the Licensee. The Licensee requested an increase in capacity from a Small to a Large Family Child Care Home on June 11, 2021. The licensee rents this single-family home, which consists of 2 bedrooms, and a bath. Present at the daycare is the Licensee, helper, and six children (3 infants and 3 preschoolers). All Adult residents have the fingerprint clearance on file. Days and Hours of operation are M - F, 8 am- 5:30 pm.

LPA and the Licensee inspect the home for Health and Safety Hazards. Daycare areas are the living room, dining room, and the front patio. Off limit areas are the two bedrooms, a kitchen, and a garage. All off-limit areas, including closets, are adequately barricaded. The home is clean and in good repair with sufficient lighting and ventilation. The Licensee has installed multiple smoke and carbon monoxide combo detectors throughout the house. There is a fully charged fire extinguisher that meets the minimum size requirement. LPA observed that the home has age-appropriate toys and equipment available for children in care. All harmful objects, including chemicals, disinfectants, and sharp objects, are made inaccessible to children. There are no bodies of water in the facility. Per Licensee, there are no firearms or weapons in the home. The Licensee has a pet cat; the Licensee stated that the cat's vaccinations are all current.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 07/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/28/2021
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: FRETES, KAREN P.
FACILITY NUMBER: 414004727
VISIT DATE: 07/28/2021
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LPA observed Licensee had posted all the required forms (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, and Emergency Disaster Plan). Also, there are hand washing, cough etiquette, and COVID-19 posters that are all posted up. The first aid kit is fully stocked and accessible. The Licensee is aware that all adults 18 years and older living in the home, including helpers, or assistants must have a criminal record clearance. Also, all adults must be associated with the facility by submitting a LIC 9182 form with a copy of a CA Driver's License or CA ID before having any contact with children in care.

Capacity limits of a Small and Large License were reviewed with the Licensee. The Licensee was reminded that when operating at a Large capacity, there must be a Helper present.

The 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 for pertussis, measles, and influenza or qualifies for an exemption pursuant to Health and Safety Code 1596.7995 and 1597.662.

The Licensee was reminded about Mandated Reporter training available on the CCLD website. In addition to the AB1207 training that must be completed every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com.

LPA has recommended approval for a Large Family Child Care License once the Fire Inspector approves the Fire Clearance.

The report was reviewed and signed by the Licensee, Karen Fretes. Today's report, 7/28/2021, and notice of site visit will be sent to the Licensee at KARENFRETES@YAHOO.COM by the close of business on 7/28/21. Confirmation of receipt is required.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021
LIC809 (FAS) - (06/04)
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