444417679-8-23-2023-07-CC-EBEN-CUYQFZ-20230823120845

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444417679
Report Date: 08/15/2023
Date Signed: 08/23/2023 12:09:28 PM

Document Has Been Signed on 08/23/2023 12:09 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	GARCIA-SANTIAGO, ANGELA		FACILITY NUMBER:	444417679
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	08/15/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Angela Garcia-Santiago		TIME COMPLETED:	01:15 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) Elizabeth Berumen met with applicant, Angela Garcia-Santiago to conduct an announced pre-licensing inspection to the home today. Applicant and her adult son (David Garcia) were present during the inspection. Adults living in the home are Applicant, her husband (Alberto Zamora Prado) and son (David Garcia). Applicant has five children living in the home (ages 17, 16, 11, 10, 4). A review of staff records on 08/14/2023 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Angela Garcia-Santiago 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. Days and hours of operation will be Monday to Saturday from 6:00 AM to 10:00 PM. Applicant has completed her Preventative Health and Safety Child Care Training on June 8, 2023, and a copy of the certification verifying completion is in file. Applicant's CPR and First Aid certifications are current and expire on May 4, 2025. Applicant rents the apartment and the Owner/Landlord Notification form (LIC 9151) is in file; how ever landlord consent LIC9149 has not been signed. Applicant states that Landlord refused to sign. LPA reminded the Applicant that she cannot care for more than 6 children unless she obtains the Owner/Landlord consent for day care. Applicant does not have liability insurance and will issue affidavit regarding liability insurance for FCCH. Applicant lives in a two story apartment. LPA inspected the indoor and outdoor areas during today's visit. LPA observed barricaded stairs. The smoke and carbon monoxide detectors were tested and proved to be functioning. LPA observed a fully charged 3A40BC fire extinguisher. Off limit areas inside the home are entire upstairs (3 bedrooms, one hall closet and bathroom). The outdoor patio area is fenced. No bodies of water were observed. Applicant states that there are no weapons in the home. Applicant has a pet dog with vaccinations. Facility Evaluation Report dated 08/15/23 to be continued on next page: - Page 1 -

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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

FACILITY NAME: GARCIA-SANTIAGO, ANGELA	FACILITY NUMBER: 444417679
	VISIT DATE: 08/15/2023

NARRATIVE

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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 Angela Garcia Santiago. During the exit interview, the Applicant confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Applicant was informed that a small family home day care license is pending the following:

1. Poisons, detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children must be stored where they are inaccessible to children.

2. The back patio needs to be cleaned and free of defect which would endanger a child. LPA observed a tiered glass shelf that is a potential risk to children. Applicant was asked to remove.

3. The back patio has items which need to be removed and Applicant agrees to barricade the left side to prevent children from accessing it.

4. Knives need to be made inaccessible.

A second pre-licensing inspection will be conducted to ensure the items were completed.

This inspection was conducted in Spanish and report was translated in Spanish.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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

FACILITY NAME: GARCIA-SANTIAGO, ANGELA	FACILITY NUMBER: 444417679
	VISIT DATE: 08/15/2023

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LPA reviewed with Angela Santiago 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. Applicant states that she will talk to children as form of discipline. 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 Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

LPA discussed the safe sleep regulations with Angela Garcia Santiago 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 Blanca Ceja 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.

LPA discussed the requirements of AB 633 with the Applicant and provided her the AB 633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and Applicant understands the requirements. LPA also discussed "zero tolerance" related regulations with the Applicant and advised her 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. 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. SB 792 Immunization Requirements was also discussed. Applicant's immunization records are on file.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

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