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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416517
Report Date: 07/07/2022
Date Signed: 07/13/2022 09:20:17 AM

Document Has Been Signed on 07/13/2022 09:20 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:GUERRERO INFANTE, NORA & QUINTANA MORALES, ARTUROFACILITY NUMBER:
434416517
ADMINISTRATOR:NORA & ARTUROFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 394-8302
CITY:SUNNYVALESTATE: CAZIP CODE:
94085
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/07/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Nora Guerrero Infante & Arturo Quintana MoralesTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Mel Matos met with Applicants, Nora Guerrero Infante & Arturo Quintana Morales, to conduct an announced prelicensing inspection at 598 Borregas Ave, Sunnyvale, CA 94085. LPA was granted access to the home by the Applicants. No children were present in the home during today's inspection. The Applicants and two adult children (Steven Quintana & Andee Quintana) are the adults residing in the home. There are no minor children residing in the home.

Days and hours of operation will be Monday - Friday from 8:00 AM to 5:00 PM. Applicants have completed their Preventative Health and Safety Child Care Training on October 10, 2022 and copies of the certifications are on file. Applicants CPR and First Aid certifications are current and expire on 02/12/2024. Applicants completed the Mandated Reporter Training for Child Care Workers on 02/18/2022 and copies of the certifications are on file. A copy of current TB test, flu, Mmr, and Tdap vaccinations for both Applicants are on file. Applicants rent the home and a copy of the lease agreement verifying control of property and Owner/Landlord Notification (LIC 9151) & Owner/Landlord Consent (LIC 9149) forms are on file. Applicants do not have liability insurance and will issue Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282). An approved fire clearance from the Sunnyvale Department of Public Safety was received on June 10, 2022.

LPA toured the indoor and outdoor areas of the home with the Applicants during today's inspection. There are not stairs or fireplace units inside the home. Off limit areas inside the home: attached garage, kitchen, and bedroom #2. There are no wall heater units inside the home. Off limit areas outside the home: left side section of the backyard, locked small storage shed, and large storage shed.

The home is clean, orderly, (including heating/air conditioning), and ventilation for safety & comfort. There is sufficient toys, supplies, and equipment for the day care children both indoors/outdoors. LPA observed a fully charged fire extinguisher (3A40BC) and working combo smoke and carbon monoxide detectors, fenced backyard, and no bodies of water. Applicants state that they do not have any weapons/ammunition in the home.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: GUERRERO INFANTE, NORA & QUINTANA MORALES, ARTURO
FACILITY NUMBER: 434416517
VISIT DATE: 07/07/2022
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Applicants state she has an indoor dog (Husky) that is vaccinated/licensed and kept in the off limits bedroom (bedroom #2) of the home. Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. Applicants states that there are no poisons in the home. LPA reminded Applicants that smoking, baby walkers, and similar items are not allowed in Family Child Care Homes. Applicant states that they will not administer any medication to the children at this time. Applicants state that a child will be isolated in the living room area if necessary due to illness or communicable disease. Applicant has a First Aid kit with a touchless thermometer in the home.

Forms of discipline used by Applicants: talking to children/redirection. Applicants understand that children's personal rights should not be violated; including no corporal punishment. isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed. LPA informed Applicants that fire/disaster drills must be practiced at least once every 6 months and documented.

Nora Guerrero Infante & Arturo Quintana Morales, Applicants, were reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 requirements of AB 633 with the Applicants. The Applicants understand the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations with the Applicants and advised them of the assessment of an immediate $500 civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

LPA provided and reviewed the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

LPA provided and discussed the safe sleep regulations with Applicants 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 Applicants 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
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: GUERRERO INFANTE, NORA & QUINTANA MORALES, ARTURO
FACILITY NUMBER: 434416517
VISIT DATE: 07/07/2022
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APPLICANTS WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS:
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: http://www.ada.gov/childqanda.htm

PIN 22-02-CCP - Best Practices Related to the Provision of Incidental Medical Services in Child Care Center and Family Care Homes was provided to Applicants.

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 platform.

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.

Exit interview conducted and report was reviewed with the Applicants, Nora Guerrero Infante & Arturo Quintana Morales, and LPA advised them that a Family Child Care Home License is approved effective today, July 7, 2022.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC809 (FAS) - (06/04)
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