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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417672
Report Date: 10/30/2023
Date Signed: 10/30/2023 12:27:34 PM

Document Has Been Signed on 10/30/2023 12:27 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
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: 11DATE:
10/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Raquel NogueraTIME COMPLETED:
12:30 PM
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On October 30th, 2023 at 10:05AM, 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 twelve (12) children and fingerprint cleared Antonette Galera. LPA toured the facility to conduct a health and safety inspection. Hours of operation are 7:00am - 6:00pm Monday through Friday.

The single story home consists of three (3) bedrooms, two (2) bathrooms, living room, kitchen, dining room, garage, backyard with storage shed. The home was neat 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: Living Room, Dining Room, Kitchen, Bathroom (hallway) and Backyard (gated portion)
OFF LIMITS AREA: Three (3) bedrooms, master bathroom, Garage and Storage shed, remaining portion of backyard

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 home. LPA did not observe any hazardous materials or toxins that are accessible to children. There are 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 by a bookcase 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: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2023
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: NOGUERA, RAQUEL
FACILITY NUMBER: 013417672
VISIT DATE: 10/30/2023
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LPA requested and reviewed the files of twelve (12) 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 10/30/2023. The licensee has a current CPR/First aid certificate which expires on 7/22/2025 and Mandated Reporter training was completed on 9/19/2023. The licensee is in ratio today. All required forms are posted and visible for public review.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days 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-andresources/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 809C for continuance.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
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: 10/30/2023
NARRATIVE
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee Noguera, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Raquel Noguera.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
LIC809 (FAS) - (06/04)
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