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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700021
Report Date: 11/09/2022
Date Signed: 11/09/2022 01:18:47 PM

Document Has Been Signed on 11/09/2022 01:18 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:VALVERDE, ARMIDAFACILITY NUMBER:
015700021
ADMINISTRATOR:VALVERDE, ARMIDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 461-0106
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
11/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Armida ValverdeTIME COMPLETED:
01:25 PM
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On November 9th, 2022 at 10:10am, Licensing Program Analyst (LPA) April Wright met with licensee Armida Valverde for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the home by the licensee. Present during inspection were three (3) children (1 infant/2 preschool age). Hours of operation are 6am - 6pm Monday through Friday.

LPA toured the facility to conduct a health and safety inspection. The home single story home was clean and orderly, with heating and ventilation for safety and comfort of children in care.

On-limit-areas: kitchen, family room, and backyard.
Off-limit areas: master bedroom with master bathroom, garage, all bedrooms, and living room. All off-limit areas are made inaccessible to children via locked and/or closed doors and visual supervision.
Isolation room: Quiet corner in day care room.

The off limits are and will be made inaccessible by closed and/or locked doors and visual supervision. There is a hot tub in the backyard and has a lock and is inaccessible to children in care. LPA did not observe any hazardous materials or toxins accessible to children during today's inspection. There are ample age appropriate toys that appear to be safe and in good condition. There are 3 play structures in the back yard that are clean, age appropriate and anchored to the ground for stability.

The home has a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detector, fully stock First Aid Kit. and telephone. Per licensee ,there are firearms kept in the home. LPA observed ammunition to be stored separately from firearms. LPA observed firearms to be locked in a gun storage safe in an off-limit area of 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: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2022
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 10
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: VALVERDE, ARMIDA
FACILITY NUMBER: 015700021
VISIT DATE: 11/09/2022
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Records Review: LPA requested and reviewed the files of three (3) children in care. The children's files contained, Parents rights, medical consent forms and identification and emergency contacts. C3 file is missing LIC 9227 - Infant Sleep Plan and Sleep Log. 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 1/12/2022. The licensee has a current CPR/First aid certificate which expires on 11/5/2024 and Mandated Reporter Training on 7/5/2021. 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 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 809 -C for continuance...

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC809 (FAS) - (06/04)
Page: 6 of 10
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: VALVERDE, ARMIDA
FACILITY NUMBER: 015700021
VISIT DATE: 11/09/2022
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 childcare 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.


No deficiencies cited during today's inspection. List of technical violations listed below (Please see attached advisory note pages for more information):

Technical Violation: Licensee has not completed fire drills as required by Licensing. Last conducted 1/12/2022.

Technical Violation: C3 has no Infant Sleep Plan (LIC9227) on File

Technical Violation: C3 has no Infant Sleep log on File

A notice of site visit was given and must remain posted 30 days. Exit interview conducted and report was reviewed with Licensee Armida Valverde.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC809 (FAS) - (06/04)
Page: 5 of 10