015700021-11-19-2021-52-CC-JWIS-C8WPFW-20211119101724

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700021
Report Date: 11/19/2021
Date Signed: 11/19/2021 10:17:35 AM

Document Has Been Signed on 11/19/2021 10:17 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	VALVERDE, ARMIDA		FACILITY NUMBER:	015700021
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 6	DATE:	11/19/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Armida Valverde		TIME COMPLETED:	10:30 AM

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 11/19/2021 at 09:00am, Licensing Program Analyst (LPA) Jonathan Williams met with Licensee (Armida Valverde) for a Case Management inspection (increase in capacity). Present for this inspection are the Licensee and six children in care (1 infant and 5 preschool-aged children). Per Licensee, 8 children are enrolled at the facility. Facility operating hours are 8:00am-6pm M-F. The facility was toured to conduct a health and safety inspection. The home is a 1-story home. On-limit-areas: kitchen, family room, and backyard. Off-limit areas: master bedroom with master bathroom, garage, bedrooms, and living room. All off-limit areas are made inaccessible to children via locked and/or closed doors and visual supervision. Isolation room: area of the family room. At 9:12am, LPA toured the facility interior. The home is tidy and clean with heating and ventilation for safety and comfort. There are safe age-appropriate toys and learning materials available to children throughout the home. Fireplace is barricaded. Wall heater located in the hallway is barricaded. All hazardous materials and toxins including disinfectants and cleaning solutions were observed to be made inaccessible to children during today's inspection. Furniture accessible to children was observed to be age-appropriate, in operable condition, and free of loose, sharp, or pointed parts. Food/beverages capable of rapid spoiling are properly stored. Uncontaminated drinking water is available to children. There are firearms kept in the home, and ammunition is stored separately from firearms. LPA observed firearms to be locked in a gun storage safe in an off-limit area of the home (garage).

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: VALVERDE, ARMIDA	FACILITY NUMBER: 015700021
	VISIT DATE: 11/19/2021

NARRATIVE

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At 9:25am, LPA toured the facility bathroom. Toilets and sinks were found to be in operable condition. LPA observed adequate amounts of paper towels and hand soap available to children in the bathroom during today's inspection. No cleaning supplies were observed to be accessible to children during today's inspection.

At 9:28am, LPA toured the outdoor play area. All play equipment was observed to be operable and age-appropriate during this inspection. High climbing equipment such as slides have cushioning material to absorb falls. The facility has a hot tub located in the backyard which is fully enclosed within a wood gazebo structure to prevent access by children. Gazebo structure is fully enclosed with a roof and four locked doors.

The facility has a fully-charged 2A10BC fire extinguisher and working telephone. Smoke/carbon monoxide detector (combined) is fully functional. CPR/1st Aid certificate for Licensee expires 7/11/2023. Mandated Reporter training for Licensee expires on 7/5/2023. The facility is in ratio today. Children's files and staff files were reviewed for proper documentation. All required forms are posted in public view. Facility conducts fire/disaster drill at least once every 6 months. Children's roster was reviewed and found to be complete. Copy of children's roster obtained.

Licensee was granted a fire clearance by Newark Fire Department on 11/10/2021. LPA discussed ratio requirements for large Family Child Care Homes and Licensee acknowledged these ratio requirements. LPA informed Licensee that whenever more than 8 children are cared for at the same time, a fingerprint cleared assistant provider must be present in the home.

Incidental Medical Services (IMS) policy was discussed. This facility does not provide IMS to children in care at this time. 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: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2021

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: VALVERDE, ARMIDA	FACILITY NUMBER: 015700021
	VISIT DATE: 11/19/2021

NARRATIVE

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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 Family Child Care Homes 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 624b). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the Licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the Licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The 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.

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.

Capacity increase is approved effective 11/19/2021. License to operate a large Family Child Care Home is recommended.

No deficiencies were cited today. A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided to the Licensee and the signature on this form acknowledges receipt of these rights. Exit interview was conducted and report was reviewed with the Licensee.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jonathan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2021

LIC809 (FAS) - (06/04)

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