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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004797
Report Date: 10/24/2022
Date Signed: 10/24/2022 09:57:25 AM

Document Has Been Signed on 10/24/2022 09:57 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:TORRES OLIVEROS, ANDREAFACILITY NUMBER:
414004797
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 3DATE:
10/24/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Licensee, Andrea Torres OliverosTIME COMPLETED:
10:10 AM
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On October 24th, 2022 at approximately 8:15AM, Licensing Program Analyst's (LPA) Tapia-Mandujano conducted an unannounced inspection for increase of capacity today and met with licensee, Andrea Torres Oliveros for her request to increase from a Small to a Large Family Child Care. Fire Clearance is still pending. Present in the home were adults living in the home. Licensee is caring for 3 children (2 infants and 1 preschool age). All adults living and working in the home have fingerprint clearance and are associated to the facility.

Licensee rents home is a two bedroom, two bathroom, one story house. Day and hours of operation are Monday- Friday: 7:30am- 5:30pm. Day-care Areas are: Living Room (Playroom), Dining Area/ Kitchen, Bedroom #1 (Napping only), Bathroom #1, and Backyard Area Off-limit Area are: Bedroom #2, Bathroom #2, and Garage (Pass through only). LPA inspected home, inside and outside, with licensee for health and safety hazards.

LPA observed home to be clean and in good repair with proper temperature and ventilation. There is a variety of age appropriate toys and equipment in the home which are in good condition. There are no pools, spas, or bodies of water on the property. Home does have a fireplace. Backyard is fenced and properly barricaded. All cleaning supplies, poisons, and other chemicals are stored inaccessible to children. There is a fully charged fire extinguisher, and a working telephone. Per Licensee, there are no weapons or firearms in the home. Per licensee, there are no pets in the home. Licensee's CPR & First Aid expires on 06/2024. Licensee's Mandated Reporter certificate expires on 10/2024. Postings were posted near main door. Licensee is reminded of NO walker, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible. Capacity limits of a Small and Large Family Child Care Home were explained.

LPA received the following documents during today's inspection: Copy of Mandated Reporter, Copy of CPR & First Aid, Copy of Lease Addendum, LIC 508 for adult son, Flu declaration to opt-out.

LPA will reccommend for approval of a Large Family Child Care Home once the following items are completed:
*LIC 508: All adults living in the home
*Updated LIC 610A
*New Lead Poisoning Requirement Training
*Fire Department Approval by San Mateo Fire Department

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapt. 1.

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

Exit interview was conducted and report was reviewed by licensee, Andrea Torres Oliveros..
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2022
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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