414004727-9-15-2022-05-CC-BVAN-CJB2GC-20220915172254

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004727
Report Date: 09/15/2022
Date Signed: 09/15/2022 05:23:49 PM

Document Has Been Signed on 09/15/2022 05:23 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	FRETES, KAREN P.		FACILITY NUMBER:	414004727
ADMINISTRATOR:	FRETES, KAREN P.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 513-1664
CITY:	BURLINGAME	STATE: CA	ZIP CODE:	94010
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	09/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Karen Fretes		TIME COMPLETED:	05:30 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 September 15, 2022., Licensing Program Analyst (LPA) Van conducted an annual 1-year mandated inspection, including inspecting the facility's interior and exterior and reviewing the required childcare paperwork with the Licensee. LPA met Karen Fretes, the Licensee, and explained the purpose of the inspection. The Licensee, her mom, and five enrolled children are at home (3 infants and 2 Pre-K children). Every adult living or working in the house has a criminal record clearance. Per Licensee, there are no changes to the physical plant, and all childcare areas remained the same. The licensee rents this apartment unit, which consists of 2 bedrooms, and a bath. Daycare areas are the living room, dining room, and the front patio. Off-limit areas are the two bedrooms, a kitchen, and a garage. Hours of operations are Monday to Friday, 8:00 am - 5:30 pm. All restricted daycare areas have been appropriately blocked off from the children. During the inspection, LPA toured and evaluated the indoor and outdoor play areas for health and safety hazards. The childcare space is clean and orderly, with age-appropriate activities, books, and play materials. Playpens and cribs are available for younger children, and cots are for older children to use for napping. LPA reminded the Licensee that there should be no toys, pillows, or objects hanging above the cribs/playpens per Infant Safe Sleep Regulation. All mattresses shall be designed for that cribs, and bedsheets should be tight-fitted. The home has sufficient heating, lighting, and ventilation and is free of defects or risks that harm children in care. There are a fully charged fire extinguisher, smoke and carbon monoxide detectors, and a functional phone. Fully stocked first aid supplies are available for children. LPA observed unused electrical outlets had child-proof covers. According to the Licensee, there are no firearms or weapons. The Licensee has a pet cat that always stays in the off-limit area and has up-to-date vaccination. Continued on page 2...

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

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: 09/15/2022

NARRATIVE

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There are no pools, spas, or other bodies of water on the premises. LPA did not observe any walkers, exersaucers, bouncers, or similar items in the home. Licensee acknowledges that smoking is prohibited in family child care homes. The Licensee posted all the required forms, such as facility License, Notification of Parent's Rights, Earthquake Preparedness checklist, and Notification of Personal Rights.

According to the Licensee, the facility serves all children breakfast, lunch, and morning and afternoon snacks except for one child, who has severe food allergen, and the family decided to bring their own food. LPA went through all of the children's records during the inspection. The Licensee maintains thorough records for all children, including vaccination records and Parent's Rights forms. LPA confirmed that each child has a complete emergency information card with the child's full name, phone number, and the location of a parent or authorized person who may be called in an emergency. The name and phone number of the child's doctor and the parent's permission for the Licensee to consent to emergency medical care. Licensee maintained proper immunization records of herself. Mandated Reporter Training and Pediatric First Aid are valid. The facility also has up-to-date Child Care liability insurance through Acord.

The Licensee stated the fire and drills are conducted monthly. The last drills were conducted on August 22, 2022.

The 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 the Licensees and the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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 registering all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

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: 09/15/2022

NARRATIVE

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The incidental Medical Services (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: www.ada.gov/childqanda.htm.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensees were informed that as of September 1, 2016, a person may not be employed or volunteer at a child care 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 Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Effective July 1, 2020, Licensee must have proof of completion of EMSA-certified lead poison training if applying for a change of location or capacity to an existing license.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

The report was reviewed and signed by Licensee Karen Fretes. No deficiencies were observed or cited today. Due to printer issues, today's report, September 15, 2022, and site visit notice will be sent to Karen Fretes by email on September 15, 2022. Confirmation of receipt is required, and a site visit notice must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022

LIC809 (FAS) - (06/04)

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