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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004782
Report Date: 12/02/2022
Date Signed: 12/02/2022 11:58:10 AM

Document Has Been Signed on 12/02/2022 11:58 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:TURCIOS, HEYDIFACILITY NUMBER:
414004782
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
12/02/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Heydi TurciosTIME COMPLETED:
12:15 PM
NARRATIVE
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On December 2,2022, at approximately 9:00 AM, Licensing Program Analysts (LPAs) Nathan Garcia and Maria Olguin-Leon conducted an unannounced case management inspection for capacity increase. LPA met with the licensee, Heydi Turcios, and her helpers, Marisol and Yanci Turcios taking care of 6 children present. The purpose of the inspection was explained to her. The licensee initiated and applied for capacity increase. Child Care Licensing received the fire clearance approval for the capacity increase request on 7/5/22. The day-care areas also have changed, utilizing the living room, one bedroom, one bathroom on lower level, backyard and additional bedroom towards the backyard. Licensee sent a copy of new facility sketch to LPM Cindy Interiano on 11/2/2022. LPAs observed and checked the added room for health and safety hazards. The room inspected is cleared and is added on the facility sketch. The children's furniture that were in good condition and repair. Cubbies were available for the children to store their belonging available near the entrance. All electrical outlets were the updated version with built-in child proof blockage to prevent children's access. The lower kitchen cabinets and drawers in the food preparation area were free of harmful and dangerous objects. The children's bathroom was clean and in order. Child proof knobs were installed to the doors to prevent children access to the off-limit area. All sharp corners were covered. Gates were installed at the stairways indoor. Two fully charged 1A10BC fire extinguisher, working smoke and carbon monoxide detectors, and first aid supplies available in the day-care. The outdoor play area was completely fenced and was padded with turf. There was a swing set and structures available for the children to play in. During the visit at 9:20 AM LPAs observed a man was walking out of the back yard area. At 10:00 AM, LPAs interviewed Licensee regarding the status of the individual living in the garage area. Per Licensee, there is no relation with them and will work on getting the person Fingerprinted as soon as possible. LPAs explained and advised that this should be done sooner to avoid citation and potential civil penalty. Approval of increase in capacity will not be approved until the individual living in the detached garage has been fingerprinted. LPAs also reviewed records of children's files in care today and observed that the files are incomplete. Licensee was missing various LIC forms and missing Immunization records for all children.

Deficiency have been cited for this visit for missing children's records.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2022
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: TURCIOS, HEYDI
FACILITY NUMBER: 414004782
VISIT DATE: 12/02/2022
NARRATIVE
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***Page 2 continued***

The home has been granted a Fire Clearance from the San Mateo Fire Department on 07/05/2022.
This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.html

A copy of this report, and the “Notice of Site Visit,” were given to the director.

A “Notice of Site Visit” must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Licensee, Heydi Turcios.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/02/2022 11:58 AM - It Cannot Be Edited


Created By: Nathan Garcia On 12/02/2022 at 11:04 AM
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: TURCIOS, HEYDI
FACILITY NUMBER: 414004782

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/12/2022
Section Cited
CCR
102421(a)

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102421(a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d).

This requirement is not met as evidenced by:
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Facility must maintain children's record of all children enrolled, including all Children's LIC forms and Immunization records and shall be readily availble for review.
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Based on observation, interview,record review, the licensee did not comply with the section cited above in as 5 out of 5 files are incomplete in the facility which poses an immediate health, safety or personal rights risk to persons in care.
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Licensee must send a copy of children's roster to LPA Garcia by 12/12/2022 via email at nathan.garcia@dss.ca.gov.

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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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Nathan Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 12/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/02/2022


LIC809 (FAS) - (06/04)
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