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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013413941
Report Date: 10/11/2022
Date Signed: 10/11/2022 12:44:49 PM

Document Has Been Signed on 10/11/2022 12:44 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:RODRIGUEZ, IRMA & MORALES FELIX, DUNIAFACILITY NUMBER:
013413941
ADMINISTRATOR:RODRIGUEZ, IRMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 656-6530
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 4DATE:
10/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Dunia Morales FelixTIME COMPLETED:
01:00 PM
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On 10/11/2022 approximately at 9:45AM Licensing Program Analyst (LPA) Kelly Phan arrived at for an unannounced required inspection, and met with co-licensee Dunia Morales Felix and her fingerprinted and associated sister. Present for this inspection was four preschoolers, the licensee, and licensee's fingerprinted and associated sister. Also residing in the home is the other licensee and her fingerprinted and associated husband. Per Dunia, she has two children between the ages of 23 and 12 years old; her adult daughter does not reside in the home as resides at San Diego. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8AM to 5PM

ON LIMITS: right-side bathroom #1, fenced backyard, living room (isolation area), dining room, left side yard (main entrance for day care children), and kitchen
OFF LIMITS: garage, all four bedrooms, master bathroom, front yard, right side yard, two outdoor sheds, and family room. Off limit areas are inaccessible by closed and/or locked doors, gates, and visual supervision.

The home is single story, which is neat and clean, with heating and ventilation for safety and comfort. At 10:00AM, LPA observed there were ample age appropriate toys that were observed to be safe and in good condition. Toxins, medicines, and hazardous items were inaccessible during today's inspection. There were a fully charged 2A10BC fire extinguisher, working carbon monoxide, smoke detectors, and telephone. The home has a fireplace but is blocked off. Per licensee, there are no firearms and no one smokes at the home. The facility has a small dog and water fountain in the front yard that is OFF limits to children. LPA also observed there was a small fish tank in the main day care area; Licensee was advised to supervise children in this area as it can potentially cause harm to children; per licensee, children are always supervised. The facility also utilizes the main day care room for sleeping as they have mats and play pens available; per licensee, the bedding and blankets are cleaned weekly. Per licensee, children bring their own lunches and snacks and only provide snacks occasionally. The licensee conducts and documents fire drill log indicates a drill was conducted 08/01/2022. SEE LIC 809 C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: RODRIGUEZ, IRMA & MORALES FELIX, DUNIA
FACILITY NUMBER: 013413941
VISIT DATE: 10/11/2022
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All required licensing documents are posted and visible for public review. At 11:00am, 6 children's files were reviewed and found that there were 6 out of 6 children files that did not have LIC 613A (Children Rights form), and one was missing LIC 627 (Consent for Medical Treatment), and two other files were missing LIC 9150 (Parent Notification of Additional Children); see LIC 809D. The facility roster was reviewed, and a copy obtained. The licensee is in ratio today. Licensees has proof of the required immunizations . The licensees and her fingerprinted and associated sister have required mandated reporter training that is completed as of 01/19/2021, 02/23/2021, and 07/27/2022. CPR and First Aid training are also valid for all licensees and her fingerprinted associated sister from 01/30/2022 to 01/01/2024. Per licensee, she does not have any children at her facility that takes any medications; the facility is also owned by the licensees and will send a copy of the deed or mortgage statement to LPA via email.

There was 1 deficiency were cited for today's inspection
Type B - 6 out of 6 children files were missing required documents such as LIC 613A, LIC 627, and LIC 9150 as well as missing a document verifying the child is attending public or private school in their files.

Appeal rights and a notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.00. Exit interview conducted and report was reviewed with licensee Dunia Morales Felix

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. SEE LIC 809 C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022
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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: RODRIGUEZ, IRMA & MORALES FELIX, DUNIA
FACILITY NUMBER: 013413941
VISIT DATE: 10/11/2022
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Incidental Medical Services (IMS) policy was discussed. This facility does not provides IMS to children in care. 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.”

Licensee 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.


Licensee was reminded that California Law requires licensed Child Care Centers 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 by phone, fax, or electronic mail. LPA informed the Facility Representative that all forms can be downloaded at www.ccld.ca.gov and encouraged the Facility Representative to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. Licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

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.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Kelly Phan
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022
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Document Has Been Signed on 10/11/2022 12:44 PM - It Cannot Be Edited


Created By: Kelly Phan On 10/11/2022 at 11:40 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: RODRIGUEZ, IRMA & MORALES FELIX, DUNIA
FACILITY NUMBER: 013413941

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102421(c)
Child's Records
(c) In any case in which the licensee cares for an additional child pursuant to Section 102416.5(b) for a Small Family Child Care Home or Section 102416.5(d) for a Large Family Child Care Home, the licensee shall maintain, in the child’s record, a copy of documentation verifying the child’s enrollment and attendance at kindergarten, including transitional kindergarten, or elementary school as required in Section 102416.5(g).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above as there were multiple documents missing from the children's files such as LIC 627, LIC 613A, and LIC 9150, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/14/2022
Plan of Correction
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Licensee would print and obtain child's parents signatures
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Jason Jang
LICENSING EVALUATOR NAME:Kelly Phan
LICENSING EVALUATOR SIGNATURE:
DATE: 10/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2022


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