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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417672
Report Date: 10/21/2022
Date Signed: 10/21/2022 11:40:04 AM

Document Has Been Signed on 10/21/2022 11:40 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:NOGUERA, RAQUELFACILITY NUMBER:
013417672
ADMINISTRATOR:NOGUERA, RAQUELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 794-1159
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
10/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Raquel NogueraTIME COMPLETED:
11:50 AM
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On October 21st, 2022 at 9:20AM, Licensing Program Analyst (LPA) April Wright met with licensee Raquel Noguera for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during inspection were 3 children (2 preschool age / 1 infant) and fingerprint cleared Antonette Galera. Hours of operation are 7:00am - 6:00pm Monday through Friday.

LPA toured the facility to conduct a health and safety inspection. The single story home was clean and orderly, with heating and ventilation for safety and comfort of children in care. The isolation area is the living room which is a section away from other children in care.

ON LIMITS AREA: Kitchen, Dining Room, Living Room, Hallway Bathroom and Backyard
OFF LIMITS AREA: All three (3) bedrooms, Garage and Storage Unit
ISOLATION AREA: Living Room

The off limits are and will be made inaccessible by closed and/or locked doors and visual supervision. There are no pools, hot tubs or any other bodies of water present in the on limit areas during todays inspection. LPA did not observe any hazardous materials or toxins that are accessible to children. There are ample age appropriate toys that appear to be safe and in good condition.

The home has a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, fully stock First Aid Kit. and telephone. There is a fireplace in that is blocked and inaccessible to children in care. Per licensee there are firearms in the home. LPA observed firearms in locked box with ammunition stored separately. Licensee also has one dog present in the home. The licensee is in compliance with the immunization laws which pertains to all childcare providers.
See LIC809-C for continuance
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2022
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: NOGUERA, RAQUEL
FACILITY NUMBER: 013417672
VISIT DATE: 10/21/2022
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LPA requested and reviewed the files of 3 children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. The facility roster was review and copies were obtained. The licensee conducts fire and disaster drills twice a year and the last was conducted on 10/19/22. The licensee has a current CPR/First aid certificate which expires on 8/14/2023 Mandated Reporter training was completed on 9/18/2022. The licensee is in ratio today. All required forms are posted and visible for public review.

Incidental Medical Services (IMS) policy was discussed. No IMS provided at facility. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

California Law requires Child Care Centers 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 by phone, fax, or electronic mail. Roster of the children must be properly maintained, and fire/disaster drill every six months must be documented.

The licensee is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

LPA discussed the Safe sleep regulations with licensee and discussed Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also inforned 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 LIC809-C for continuance...
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2022
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: NOGUERA, RAQUEL
FACILITY NUMBER: 013417672
VISIT DATE: 10/21/2022
NARRATIVE
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Licensee was reminded that all adults 18 and over, 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 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.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.


There are no deficiencies cited. A notice of site visit was given and must remain posted 30 days. Exit interview conducted and report was reviewed with Licensee Raquel Noguera.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2022
LIC809 (FAS) - (06/04)
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