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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700394
Report Date: 11/20/2023
Date Signed: 11/20/2023 12:55:47 PM

Document Has Been Signed on 11/20/2023 12:55 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:TICLLACURI APONTE, WILLIAMFACILITY NUMBER:
435700394
ADMINISTRATOR:TICCLACURI APONTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 841-2996
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/20/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:William Ticclacuri AponteTIME COMPLETED:
01:00 PM
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On Monday, November 20, 2023 at 10:30 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an announced Pre Licensing Visit. LPA met with the Applicant, William Ticclacuri Aponte and explained the nature of the site visit. The Applicant submitted a Family Child Care Home (FCCH) large license and the Oakland South Child Care Regional Office received the application on 10/31/2023. The Milpitas Fire Department inspected and approved the home on 11/9/2023. Present on the visit were the Applicant's Assistant Provider Amalia and there are no children in care today.

The home operates from Sunday at 9 pm to Friday at 6 pm. LPA discussed to the Applicant the Overnight Care regulation and Applicant understood.

LPA toured the home to conduct a Health and Safety Inspection with the Applicant. 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 living room, family room, hallway bathroom, Kid's Area Bedroom for napping and the front yard. The front yard is completely fenced and is being used as an outdoor play area. Also, the applicant is using the nearby park as an outdoor play area and LPA reminded the applicant about outdoor play at the park shall be supervised by the licensee or caregiver. The applicant understood.

The OFF-LIMIT AREAS are the applicant's bedroom, master bedroom, master bath, kitchen, dining room backyard and the garage which will be inaccessible to children in care by safety fates, closed and or locked doors and or a fence with visual supervision. The designated isolation area for a child who becomes ill while in care is the living room. There are ample age appropriate toys that appear to be safe and in good condition. There are no pools, hot 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.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2023
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: TICLLACURI APONTE, WILLIAM
FACILITY NUMBER: 435700394
VISIT DATE: 11/20/2023
NARRATIVE
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LPA observed 3 pet dogs and LPA reviewed the dogs vaccination records. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector and working telephone. The fireplace is blocked by bookshelves to prevent access by children. Per the applicant, there are no firearms in the home.

The applicant completed the Health and Safety training completed on 10/23/2023, and CPR (Pediatric) and First Aid completed on 03/5/2023. The Applicant Assistant Provider CPR (Pediatric) and First Aid completed on 12/12/2021 with validity period of 2 years. The applicant completed the AB1207 Child Care Providers training online on 10/4/2023 and the Applicant Assistant Provider completed on 6/12/2023. LPA reminded the applicant that AB1207 requires a 2-year renewal. The Applicant and the Applicant Assistant Provider have records of Measles and Pertussis immunization, Influenza declination statement and TB clearance. LPA reminded the applicant that only the Influenza vaccination can be decline with a written declination. LPA reviewed the applicant's Tax BIll Statement for the tax year 2023-2024.

LPA discussed the Staffing Ratio and Capacity for a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10.

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 the applicant 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 the 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.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023
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: TICLLACURI APONTE, WILLIAM
FACILITY NUMBER: 435700394
VISIT DATE: 11/20/2023
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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, 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.
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.

The home is recommended for a FCCH Large License effective today, 11/20/2023.

Exit interview conducted and report was reviewed with the applicant, William Ticclacuri Aponte.

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

DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023
LIC809 (FAS) - (06/04)
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