434417441-9-27-2024-07-CC-MSMS-D9HU89-20240927152111

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417441
Report Date: 09/27/2024
Date Signed: 09/27/2024 03:21:16 PM

Document Has Been Signed on 09/27/2024 03:21 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	PUENTES, LILIANA		FACILITY NUMBER:	434417441
ADMINISTRATOR/ DIRECTOR:	LILIANA PUENTES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 518-1633
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94086
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/27/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Liliana Puentes		TIME VISIT/ INSPECTION COMPLETED:	04:00 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	Licensing Program Analyst (LPA) Mel Matos met with Liliana Puentes, Applicant, to conduct an announced prelicensing (change of location) inspection at 932 W Olive Ave, Sunnyvale CA 94086. Applicant is currently licensed as a large Family Child Care Home (#434416341). LPA was granted access to the home by the Applicant. No other adults or day care children were present in the home during today's inspection. Applicant, Applicant's spouse (Sergio Cristancho), and oldest daughter (Isabella Cristancho) are the adults residing in the home. There is one minor child (age 14 years) residing in the home. Days and hours of operation will be Monday - Friday from 8:00 AM to 5:30 PM. Applicant completed her Preventative Health and Safety Training on 04/16/2022 and a copy of the certification is on file. Applicant's CPR and First Aid certifications are current and expire on 09/14/2025. Applicant completed the Mandated Reporter Training for Child Care Workers on 04/28/2024 and a copy of the certification is on file. A copy of current TB test, Mmr, Tdap, and flu (opt out)vaccinations for the Applicant are on file. Because the Applicant rents/leases the home, proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the Applicant confirms was provided to the property owner/landlord. Applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). Copies of both documents are on file. Applicant provided proof of control of property to the Department prior to today’s inspection and a copy of the lease agreement is on file. Applicant currently has liability insurance through Markel Insurance Company at her licensed location and will transfer the policy over to the new location once she gets the change of location approved. LPA toured the indoor and outdoor areas of the home with the Applicant during today's inspection. The home has two levels (upstairs & downstairs) and LPA observed barricaded stairs on the lower portion of the stairs during today's inspection. There are no fireplace or wall heater units inside the home. Off limit areas inside the home (entire upstairs): Master bedroom, bedrooms 2, 3, & 4, and two bathrooms. Off limit areas inside the home (downstairs): barricaded fireplace and attached garage. Off limit areas outside the home: front yard and left side area of the backyard. The home is clean, orderly, including heating and ventilation, for safety & comfort. Applicant has a valid phone in the home (#650-518-1633). There is sufficient toys, supplies, and equipment for the day care children both indoors/outdoors. Applicant understands that she must be present in the home at least 80% of the operating hours of the day care on a daily basis and ensure that the children are supervised at all times. Applicant understands her capacity options and she understands that she cannot have more than 14 children in the home at any time with at least two qualified adults.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PUENTES, LILIANA	FACILITY NUMBER: 434417441
	VISIT DATE: 09/27/2024

NARRATIVE

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LPA observed a fully charged fire extinguisher (3A40BC), working combo smoke & carbon monoxide detectors, no bodies of water, and fenced backyard. Applicant states that she does not have any weapons/ammunition in the home. Applicant states that she has one dog (Cockapoo) that she will keep in the off limit upstairs areas during day care hours. Applicant states that her dog is licensed and vaccinated. Applicant states that she provides breakfast, lunch, and PM snack to the day care children. Applicant understands that any food or drink brought from home shall be labeled with each child's name and properly stored.

Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. Applicant states that any poisons will be kept in the off limits attached garage. LPA reminded Applicant that smoking, baby walkers, and similar items are not allowed in Family Child Care Homes. Applicant states that a child will be isolated in the main classroom area if necessary due to illness or communicable disease. Applicant has a First Aid kit with a touchless thermometer in the home. Applicant states that she does not transport children via vehicle and that she understands that children cannot be left in parked vehicles unattended at any time.

Forms of discipline to be used by Applicant: talking to children. Applicant understands 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 the Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

Applicant states that she will not administer any medication to the children at this time. 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) or (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.

Liliana Puentes, Applicant, was 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, 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.

LPA reviewed with Liliana Puentes, Applicant, 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. Prelicensing Entrance Checklist – Family Child Care Homes (LIC 9280) was provided to the Applicant.

A fire safety inspection approval was received from the Sunnyvale Department of Public Safety on September 24, 2024.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PUENTES, LILIANA	FACILITY NUMBER: 434417441
	VISIT DATE: 09/27/2024

NARRATIVE

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LPA discussed the safe sleep regulations with Liliana Puentes, Applicant, and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed Liliana Puentes, Applicant, 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.

On this date, 09/11/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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-carelicensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Applicant, Liliana Puentes. Applicant states that she will be starting her day care at this location as of Monday September 30, 2024.

LPA advised the Applicant that a large Family Child Care Home license will be approved effective Monday September 30, 2024.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

LIC809 (FAS) - (06/04)

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