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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415784
Report Date: 01/06/2022
Date Signed: 01/06/2022 12:29:45 PM

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:HEREDIA ANTON, MARIAFACILITY NUMBER:
434415784
ADMINISTRATOR:HEREDIA ANTON, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 630-9036
CITY:PALO ALTOSTATE: CAZIP CODE:
94301
CAPACITY:14CENSUS: 8DATE:
01/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Maria Heredia AntonTIME COMPLETED:
12:30 PM
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On 01/06/2022 at approximately 8:30am, Licensing Program Analyst (LPA) Sabina Dodoo met with licensee Maria Heredia Anton for an UNANNOUCED ANNUAL REQUIRED INSPECTION for a Family Child Care Home. Present for the inspection were licensee, two aides and 8 children. The total children enrolled are 12 and the census was 8 at the time of the inspection. The Family Child Care Home is within ratio. The Family Child Care Home was toured to conduct a Health and Safety Inspection. The center currently operates Monday through Friday from 8am to 5:00pm.
The Family Child Care Home is a single story home with one bedroom, one bathroom, one kitchen, one living room, an indoor patio, a dining area turned into a playroom. There is a fence all around the house and the front yard has tables and benches for outdoor activities. The children’s cubbies are located in the outdoor activity area and has their names on them. There are green mats all around the outside of the house to absorb falls. There are no play structures but there is a sandbox for manipulative play. There are arts and craft materials and books for learning. There are sleeping cots available for each child. The entrance of the Family Day Care Home is the gate leading to front yard of the home, that leads to the indoor patio. Throughout the day the licensee updates parents with activities through text messages, email and sending photos. LPA (Dodoo) observed the outdoor activity areas to be neat with proper ventilation and materials equipped to care for the children. LPA (Dodoo) observed the bulletin board (parent’s rights, emergency disaster plan, earthquake drills and facility license). The current menu and schedule for the day is posted. The licensee provides lunch and snacks for the children. Licensee also provides water by using filtered tap water. Each child has their own water bottles with their names. There is no fireplace on the premises. There are no bodies of water on the premises. There are no firearms on premises. All chemicals are kept out of reach of the children. All sharp objects(knives/scissors) are kept out of reach of children. The cabinets in the kitchen have safety locks. The bathroom has pumping soap and paper towels to dry hands. CONTINUATION ON LIC 809C
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
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 4
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: HEREDIA ANTON, MARIA
FACILITY NUMBER: 434415784
VISIT DATE: 01/06/2022
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The OFF-LIMIT AREAS are the bedroom, and the garage

The ON-LIMIT AREAS the indoor patio, the playroom, the living room, the outdoor activity areas and the bathroom.

All hazardous materials and toxins are kept out of reach from children and are not accessible. The Family Child Care Home has one fully charged fire extinguisher 3A-10- 40 BC, a working smoke detector, a working carbon monoxide, telephone and fully stocked first aid kits. The furniture around the playroom and outdoor activity area are all child proof and adequate for children to use. The learning materials are organized, and toys are kept in safety bins and cabinets for easy access for the children.

The licensee has completed the Health and Safety training and CPR/First Aid is current. The licensee is following the immunization laws and have completed the mandated reporter training. The Licensee conducted and documented the fire and disaster drills twice a year and the last conducted drill was on December of 2021. All required forms are posted and visible for public view.

At 11am LPA (Sabina Dodoo) reviewed 4 children’s files and 3 staff files(licensee file included) and documented them on LIC 857 and LIC 859. An updated roster was viewed by LPA and a copy was obtained from licensee. The staff interview was completed with Licensee Maria Heredia Anton.

Incidental Medical Services (IMS) policy was discussed. This facility does not provide IMS (Incidental Medical Services) to children currently. If 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

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: HEREDIA ANTON, MARIA
FACILITY NUMBER: 434415784
VISIT DATE: 01/06/2022
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.Licensee was reminded that all adults 18 and over working in Child Care Center, 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 Child Care Center. 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 safe sleep regulations with licensee 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.

Licensee was reminded of the responsibility as a mandated reporter and the trainings must be done once every two years as well as CPR/First Aid needs to be renewed every two years and must be EMSA approved. LPA also encouraged licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded. For licensing updates and Quarterly Child Care Distribution email, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: HEREDIA ANTON, MARIA
FACILITY NUMBER: 434415784
VISIT DATE: 01/06/2022
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Effective August 1, 2003 California Law requires Child Care licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624 within 7 business days.

There were no deficiencies cited during today’s inspection. A notice of site visit was given and must remain posted for 30 days. Exit Interview and staff interview was conducted with Licensee (Maria Heredia Anton) at 12pm. This report shall remain on file for the next 3 years.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Sabina DodooTELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
LIC809 (FAS) - (06/04)
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