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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414452
Report Date: 07/17/2023
Date Signed: 07/17/2023 02:19:37 PM

Document Has Been Signed on 07/17/2023 02:19 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:ORTEGA, SILVIAFACILITY NUMBER:
434414452
ADMINISTRATOR:ORTEGA, SILVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 394-2550
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
07/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Silvia OrtegaTIME COMPLETED:
02:45 PM
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On Monday July 17, 2023 at 1:30 PM, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required One (1) Year visit. LPA met with the Licensee Silvia Ortega and explained the nature of the visit.. Present on this visit were the Licensee's 2 Assistants, Licensee's son who is a preschool, 1 infant child and 5 preschool children. The facility operates from Monday to Friday from 6:30 am to 5:30 pm.

LPA toured the facility to conduct a Health and Safety inspection with the Licensee. The home is a one-story home. The home is neat and clean with heating and ventilation for safety and comfort.
The ON LIMIT AREAS (accessible to children in care) are the baby room, preschool room, hallway bathroom, master bedroom use for Isolation room only and the backyard. The BACKYARD play area is completely fenced.
The OFF-LIMIT AREAS are bedrooms number 2 and 3, kitchen, side yards and the garage which will be inaccessible to children in care by closed and or locked doors and or a fence with visual supervision. There are a child gates located in the home to prevent children in the Off-Limit Areas. There are ample age appropriate toys that appear to be safe and in good condition. There are no pools, tubs or any other bodies of water present during today's inspection. All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible today.

The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector and working telephone. The fireplace is screened to prevent access by children. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills on 06/21/23 and 07/10/2023. Licensee does not own the premises and has a CHILD CARE LIABILITY INSURANCE with MRA Insurance Agency.

SEE 809 C.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2023
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: ORTEGA, SILVIA
FACILITY NUMBER: 434414452
VISIT DATE: 07/17/2023
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The licensee has a current CPR and First Aid certificate expires on July 30, 2023 and completed the CHILD CARE PROVIDERS MANDATED REPORTER TRAINING training taken online on May 23, 2022. The licensee and the assistants have records of Measles and Pertussis immunization, Influenza vaccination and TB clearance. LPA reminded Licensee that only the Influenza vaccination can be decline with a written declination.

Facility roster of children was reviewed. Children’s files were reviewed, which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, LIC 9227, Sleep Logs, and Immunization. The licensee is in ratio today.

Licensee stated that she does not transport children at this time. Licensee has a current and valid Driver License. Licensee understands that children cannot be left in parked vehicles unattended at any time.

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: http://www.ada.gov/childqanda.htm

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.


SEE 809 C.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023
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: ORTEGA, SILVIA
FACILITY NUMBER: 434414452
VISIT DATE: 07/17/2023
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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 informed the Licensee CDSS has revised the ARPA survey to meet federal requirements. As a result, all child care providers must complete anew American Rescue Plan Act (ARPA) survey by August 15, 2023.

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/inspection-process.

There are no deficiencies cited on this visit.

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

Exit interview conducted and report was reviewed with the licensee, Silvia Ortega.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023
LIC809 (FAS) - (06/04)
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