015700307-2-2-2023-52-CC-MMAW-CNNW4B-20230202155716

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700307
Report Date: 02/02/2023
Date Signed: 02/02/2023 03:57:28 PM

Document Has Been Signed on 02/02/2023 03:57 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:	DE SANTIAGO, MARIA		FACILITY NUMBER:	015700307
ADMINISTRATOR:	DE SANTIAGO, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 329-5935
CITY:	NEWARK	STATE: CA	ZIP CODE:	94560
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 6	DATE:	02/02/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Maria De Santiago		TIME COMPLETED:	04:15 PM

NARRATIVE

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On 2/2/23 at 1:00 PM Licensing Program analysts (LPA) Michael Mathew and Andrew Elliot Conducted an unannounced annual visit LPA met with Licensee Maria De Santiago and discussed the purpose of the Visit. Prior to entering the home LPA conducted Covid-19 screening questions. Licensee and LPA, toured inside and out of the home. At the time of the visit there were 5 children and 2 adult. There are age-appropriate toys and equipment for children in care.

Licensee uses bedroom, playroom, Kitchen, hallway bathroom, and backyard for the day-care. Licensee stated that there are no guns/weapons or ammunition in the home. LPA observed the knifes are kept in a cabinet next to the sink, inaccessible to children. LPA observed chemicals and toxins are kept in the cabinet next to the sink, which is inaccessible to children in care. Backyard is fully fenced in and have ample number of toys and equipment for children in care. LPA observed no bodies of water during inspection. LPA observed a 2A10BC fire extinguisher present and in working condition. Fire alarm and carbon monoxide detector are good and in working condition. Licensees CPR/first aid is current and is valid until 7/10/23. Licensee presents have current mandated reporter training valid until 3/2/2024. Fire drill was conducted on 11/3/22. LPA observed staff (S1) present and caring for children at the facility. S1 is not fingerprinted or associated to the facility. Licensee stated S1 has been working at the facility only today (2/2/23) due to an emergency licensee had to attend to. Licensee stated, Licensee was going to hire S1 within the next 2 weeks once S1 fingerprints were cleared.

The facility is currently not providing Incidental Medical Services. 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

Cont.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Michael Mathew
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

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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Document Has Been Signed on 02/02/2023 03:57 PM - It Cannot Be Edited

Created By: Michael Mathew On 02/02/2023 at 02:21 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: DE SANTIAGO, MARIA	FACILITY NUMBER: 015700307
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/02/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102370(d)

Criminal Record Clearance

(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above in which poses an immediate health, safety or personal rights risk to persons in care. LPA observed staff (S1) present and caring for children at the facility. S1 is not fingerprinted or associated to the facility. Licensee stated S1 has been working at the facility only today (2/2/23) due to an emergency licensee had to attend to. Licensee stated, Licensee was going to hire S1 within the next 2 weeks once S1 fingerprints cleared.
	POC Due Date: 02/06/2023
	Plan of Correction
1 2 3 4	Licensee agreed that assistant will not be at the facility until assistant is cleared. Licensee will submit a written plan how to prevent a similar occurrence in the future. Written plan must be submitted by end of day Monday 2/6/2023

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Wynn Norona

LICENSING EVALUATOR NAME:

Michael Mathew

LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: DE SANTIAGO, MARIA	FACILITY NUMBER: 015700307
	VISIT DATE: 02/02/2023

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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 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.

LPA Mathew informed licensee Maria De Santiago that this report dated 2/2/23 document One Type A citation and should be posted for 30 consecutive days. LPA Mathew informed the licensee Maria De Santiago to provide a copy of this licensing report dated 2/2/2023 that documents a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

One Type A deficiency was cited during today's inspection. A civil penalty of $100 has been assessed. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Maria De Santiago.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Michael Mathew
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

LIC809 (FAS) - (06/04)

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