<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422718
Report Date: 09/28/2022
Date Signed: 09/28/2022 04:54:46 PM

Document Has Been Signed on 09/28/2022 04:54 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ESGUERRA, JOSEPHINE & BIENVENIDOFACILITY NUMBER:
013422718
ADMINISTRATOR:ESGUERRA, JOSEPHINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 263-8335
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
09/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Josephine and Bienvenido EsguerraTIME COMPLETED:
04:00 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
On 09/28/2022 Licensing Program Analyst (LPA) Arminder Singh met with Licensee, Josephine and Bienvenido Esguerra and explained the purpose of today's visit. There are 7 child present today. Children were engaged in various activities when LPA arrived. LPA reviewed record of four (4) children today (C1-C4). Child's file included Licensing documents per regulation. The home was toured to conduct a health and safety inspection. The Licensee's hours of operation are Monday-Friday, 6:00AM-6:00PM. Licensee has a working telephone in the home.

The home is a one story home with a garage located in the back of the home. The home consists of a living/dining room, kitchen, 3 bedrooms, 2 bathrooms, and a backyard.

ON LIMIT AREAS are the living/dining room, kitchen, bathroom #1, and the backyard.

OFF LIMITS the remainder of home is off limits which will be made inaccessible by closed and or/locked doors and visual supervision.

Outdoor Play area is fully fenced and has a padded surface. Outdoor play area requires 100% supervision. The outdoor play area is free from defects or dangerous conditions. There are no pools, hot tubs or any other bodies of water. There are ample age appropriate toys that appear to be safe and in good condition. All hazardous materials and toxins are kept out of reach of children.

ISOLATION AREA will be the dining room.



CONTINUED ON NEXT PAGE
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2022
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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ESGUERRA, JOSEPHINE & BIENVENIDO
FACILITY NUMBER: 013422718
VISIT DATE: 09/28/2022
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
26
27
28
29
30
31
32
The home is sanitary, safe and orderly, with central heating and ventilation for safety and comfort. LPA observed required Postings on the wall as you enter the home. LPA observed: fully charged 3A40BC fire extinguisher, working smoke and carbon monoxide detector. Medicines, cleaning products, sharp objects are stored inaccessible to children in cabinets and out of reach of children. LPA reminded Licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. Licensee does not have any firearms at facility. Licensee does have a fish tank located in living room.

The Licensee has current CPR and First Aid certification.(expires 02/2024) LPA reminded Licensee that the mandated reporter training certificates are to be renewed every two years. Licensee was reminded that fire/disaster drills are to be conducted every six months.


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
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ESGUERRA, JOSEPHINE & BIENVENIDO
FACILITY NUMBER: 013422718
VISIT DATE: 09/28/2022
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
26
27
28
29
30
31
32
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/inspection-process.

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.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensees 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.

There were no deficiencies in today's visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Licensees, Josephine and Bienvenido Esguerra.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3