435700371-11-10-2022-52-CC-SDOO-CL2PVD-20221110103859

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700371
Report Date: 11/10/2022
Date Signed: 11/10/2022 10:39:18 AM

Document Has Been Signed on 11/10/2022 10:39 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	CAMPERO, LUIS & LOPEZ, KARLA		FACILITY NUMBER:	435700371
ADMINISTRATOR:	CAMPERO, LUIS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 537-8064
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	11/10/2022
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Luis Campero & Karla Lopez		TIME COMPLETED:	10:31 AM

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 Thursday 11/10/2022 at approximately 9:30am Licensing Program Analyst (LPA) Sabina Dodoo met with Licensees Luis Campero and Karla Lopez to conduct an Announced Change in Location Pre-Licensing Inspection. At the time of the inspection Licensees were the only one present in the home.

The home is a two -story residential home. LPA Dodoo, and the licensees toured the home inside and outside for a health and safety inspection. The home consists of two living rooms, dining room, kitchen, 3 bathrooms, 3 bedrooms, a laundry room, an attached garage and an upstairs non- living space. The home is equipped with working carbon monoxide detector, smoke detectors and a fully charged 2A-10-BC fire extinguisher. The home has heating and ventilation for safety and comfort. Per the Licensees there are no firearms in the home. Licensee has a current copy of a lease which shows Luis Campero and Karla Lopez have control of the property. CPR/ First Aide is current from 8/21/2021 to 8/21/2023 for Karla Lopez. For Luis Campero CPR/First Aide is current from 9/2022 until 9/2024. After a review of the file the licensees have completed the Mandated Reporter Training which will expire on 9/18/2024 for Luis Campero and 10/9/2023 for Karla Lopez. Licensee is adhering to the immunization laws as it is required for all day care providers.

Per Licensee the operating hours of the Family Child Care Home will be Monday through Friday from 7:30am to 5:00pm.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Sabina Dodoo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: CAMPERO, LUIS & LOPEZ, KARLA	FACILITY NUMBER: 435700371
	VISIT DATE: 11/10/2022

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
26
27
28
29
30
31
32

Licensee has requested the following rooms to be ‘on limits’ to day-care children: second living room(activity room), two bedrooms in the hallway, the entire backyard and the hallway bathroom.

Licensee has requested the following rooms to be ‘off limits’ to day care children: third bedroom located near the hallway, next to a bathroom that is off limits, second bathroom behind the two bedrooms that are on limits, the patio, the garage and the upstairs non-living space.

LPA Dodoo, discussed and reiterated documents that go into a child’s facility file and documents which are to be posted for parental view. There are no bodies of water on the premises.

Licensees Luis Campero and Karla Lopez, 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 Sabina Dodoo, discussed the safe sleep regulations with licensees Luis Campero and Karla Lopez, 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.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Sabina Dodoo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: CAMPERO, LUIS & LOPEZ, KARLA	FACILITY NUMBER: 435700371
	VISIT DATE: 11/10/2022

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
26
27
28
29
30
31
32

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to emailchildcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

This home is being recommended for licensure.

Exit interview conducted and report was reviewed with the licensees Luis Campero and Karla Lopez.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Sabina Dodoo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3