434413653-9-1-2023-52-CC-MPRE-CV9QYD-20230901123458

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434413653
Report Date: 09/01/2023
Date Signed: 09/01/2023 12:35:11 PM

Document Has Been Signed on 09/01/2023 12:35 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	TERRAZAS, AMOR		FACILITY NUMBER:	434413653
ADMINISTRATOR:	TERRAZAS, AMOR		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 468-1788
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 17	CENSUS: 12	DATE:	09/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:37 AM
MET WITH:	Amor Terrazas		TIME COMPLETED:	12:32 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 9/1/2023 at 9:37am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Amor Terrazas for a Required – 1 Year Inspection. Present during the inspection was the Licensee, her three (3) helpers, Amira Bustos, Karina Rodriguez Tapia and Melba (Lizeth) Galyis, two (2) infants and ten (10) preschool age children. Licensee’s husband, Gaston Olvera was present when LPA arrived, but left shortly after. Licensee lives in the home with her husband. Licensee stated her adult son, and two minor sons live in a home across the street from the facility. The facility operates 8:30am – 4:30pm, Monday – Friday. ON LIMITS AREA: Playroom (used for infants), Living Room (used for preschoolers), Kitchen, Hallway Bathroom, Backyard (used for preschool outside area), and Deck (Used for infants outside area) OFF LIMITS AREA: 1^st Bedroom on right side of hallway (used as an office), 2^nd Bedroom on the right side of the Hallway (used as storage), Master Bedroom and Bathroom ISOLATION AREA: Living Room and Playroom The facility is a single-story home rented by the Licensee. Families use the gate on the right side of the home as the entrance. The inside of the home was observed to be neat, clean with ample age-appropriate materials for the children. All toxins, cleaning products, personal medications, and hazardous materials were observed to be in inaccessible areas. Licensee stated that she provides all snacks for the children. All children bring their lunch from home. All food that is brought from the children’s home will be properly labeled and stored. All off limit areas are made inaccessible with locks, gates, and closed doors. Licensee stated she does not transport children. All napping equipment is clean and free from defects. Licensee uses cots for the older children and play yards for infants. There are no pets and no firearms in the home.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: TERRAZAS, AMOR	FACILITY NUMBER: 434413653
	VISIT DATE: 09/01/2023

NARRATIVE

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There is a fully charged 3A40BC fire extinguisher in the infant playroom. There is one (1) working smoke detector in the hallway, living room, and the office. There is one carbon monoxide detector by the front door of the home. The fireplace in the living room is screened with materials placed in front making it inaccessible to the children. Licensee holds a waiver for the fireplace to remain unscreened as well. The home is equipped with plenty of windows and screened, locking doors for proper ventilation. The home is equipped with central heat. There is also an air conditioning unit in the living room.

The backyard is fully fenced with ample age-appropriate materials for the children. There is a shaded area that is used as an arts and crafts area, water tables, a playhouse area and a play structure that is bolted into the ground and has extra cushion underneath the slide for extra safety. The left side of the backyard is off limits with a functioning chicken coop. There is plenty of shade outside for the children as they spend most of their time outside as long as the weather permits.

Licensee is operating within their licensed capacity and is in ratio. Licensee’s Health and Safety training has been completed and EMSA approved Pediatric CPR & First Aid is complete and expires 4/7/2025. Licensee’s Mandated Reporter training is complete and expires 8/20/2025. All required forms are posted on the wall in the infant play area. Fire/Disaster drills have been completed with the last drill logged 8/14/2023. All adults living in the home have obtained a criminal record clearance. LPA obtained the facility files, the helpers files and a sample of the children’s files. All files were complete.

No deficiencies were cited during LPA’s inspection.

Licensee was reminded that California law requires Licensees to report unusual incidents and/or injuries to children in care, to the child's parents, and to the Department within 24 hours by phone, fax, or email. Within seven (7) days from the incident, Licensee’s must submit the Unusual Incident/Injury form (LIC 624B) to the Department. Licensee was reminded that any structural changes or additions to the home must be reported to Community Care Licensing.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: TERRAZAS, AMOR	FACILITY NUMBER: 434413653
	VISIT DATE: 09/01/2023

NARRATIVE

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Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting https://mandatedreporterca.com/. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov.

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/.

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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Amor Terrezas, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: TERRAZAS, AMOR	FACILITY NUMBER: 434413653
	VISIT DATE: 09/01/2023

NARRATIVE

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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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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.

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

Exit interview conducted and report was reviewed with the Licensee Amor Terrazas.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

LIC809 (FAS) - (06/04)

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