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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423724
Report Date: 01/26/2023
Date Signed: 01/26/2023 04:39:38 PM

Document Has Been Signed on 01/26/2023 04:39 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CAMBEROS,L., CASTRO, G., & ESQUIVEL, A.FACILITY NUMBER:
013423724
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
01/26/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:L. Camberos, G. Castro, A. Esquivel, M. CastroTIME COMPLETED:
04:50 PM
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Licensing Program Analyst Lisa Dyer conducted an announced pre-licensing inspection. Present were the applicants Laura Camberos, Gerardo Castor and Angela Esquivel. Also present was Monzerrat Castro, who translated. The home was toured for a Health and Safety Inspection. Applicants are fingerprint cleared.
Facility Location: At 1:30 p.m., the home was toured and consists of 4 bedrooms, 3 bathrooms, living room, dining room, kitchen, day care area, and day care nook. Applicants will be utilizing the day care area, day care nook and back bathroom for the day care area. These areas will be inaccessible by closed and/or locked doors; door knob covers; gates and visual supervision.
Facility Review: Home is neat and clean, with heating and ventilation for safety and comfort. Children will sleep on cots or playyards. There is child-sized furniture, toys and play space at the facility. Isolation area for sick children will be in the day care nook. There are no toxins accessible today. There is a 3-A:40-B:C fully charged fire extinguisher, a working smoke detector (tested), carbon monoxide detector (tested) and a first aid kit. Per applicants, there are no firearms or bodies of water on the premises. Applicants have cell phones.
Backyard is securely fenced. There does not appear to be any dangerous hazards in the backyard such as poisons or toxins. Pets consist of 2 small dogs.
Applicant Training: Applicants have completed Orientation Training, Preventative Health Training, Mandated Reporter Training, and CPR/First Aid Training. Applicants are renting the property.
Technical Assistance During Inspection: LPA reviewed with applicants the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children's forms/records, facility forms/records, and information to be posted.
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. (continued)
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CAMBEROS,L., CASTRO, G., & ESQUIVEL, A.
FACILITY NUMBER: 013423724
VISIT DATE: 01/26/2023
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Applicants were instructed to conduct and document periodic fire and disaster drills. Discipline methods were discussed. Applicant was instructed that spanking is not allowed. Proposed hours of operation: 7:030 am - 5:30 pm.
LPA discussed the safe sleep regulations with the applicants, 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 applicants of the importance of checking for recalled infant devices on the Unites 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.
Applicants was informed that baby bouncers, johnny jumpers, and saucer chairs were not allowed in the home. Applicants was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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. Also discussed: children in parked vehicles; substitutes; changes to the facility; fingerprinting/association; advertisements; on-limit areas, large family child care homes, smoking and Zero Tolerance Regulations. Applicants were reminded that Mandated Child Abuse Training, as well as First Aid/CPR training is required to be completed every 2 years.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Or, For CCL Updates, go to www.ccld.ca.gov. Click the "Receive Important Updates" box. Enter your e-mail address for the Child Care Advocate Program.

Applicants were given Title 22 regulations, and was requested to enroll in Guardian Background Check to manage their employee roster and manage the background check process. (continued)
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CAMBEROS,L., CASTRO, G., & ESQUIVEL, A.
FACILITY NUMBER: 013423724
VISIT DATE: 01/26/2023
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Websites:
Community Care Licensing: https://www.cdss.ca.gov
Mandated Reporter Training - www.mandatedreporterca.com. (Child Care Providers Module).
Alameda County Public Health Department Website: www.acphd.org
Guardian Background Check: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Applicants were requested to complete the following item(s) prior to the issuance of a license:
1. Remove the washer and dryer on the side of the home.
2. Move toy in day care area next to heater.
3. Block storage area under back stairwell (plastic fence, safety fence, furniture, etc).

Applicants state that items will be completed within 10 calendar days. (Additional information may be requested.)

Exit interview conducted and report was reviewed with the applicants Laura Camberos, Angela Esquivel and Gerardo Castro. Appeal rights were given.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC809 (FAS) - (06/04)
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