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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700335
Report Date: 03/01/2023
Date Signed: 03/01/2023 02:44:17 PM

Document Has Been Signed on 03/01/2023 02:44 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:ARMENTA, MONICAFACILITY NUMBER:
015700335
ADMINISTRATOR:ARMENTA, MONICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(732) 997-8190
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
03/01/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Licensee, Monica ArmentaTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee, Monica Armenta for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during this inspection was Licensee, and two helpers supervising 4 infants and 4 preschoolers. Licensee lives in the house with her husband and two children. The home is single story home with 4 bedrooms, 3 bathrooms, living room, family room, kitchen, dining room, laundry room, garage, and back yard. The hours of operation are 7:00am to 5:30pm Monday -Friday.

Day care areas are the living room, dining room, kitchen, family room, Bathroom adjacent to the laundry room and backyard.


Off-limit-areas: hallway with all the bedrooms,2 bathrooms and garage and made inaccessible to children by locked doors, safety gates and visual supervision.

LPA inspected the house for health and safety hazards. Daycare Area is clean, orderly, and equipped with age appropriate toys and equipment for children, indoors and outdoors. Home has a working telephone, a working smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. There are no bodies of water in the day care area. There is a fireplace in the daycare room which is fully barricaded with toy shelf. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 01/09/2023. There are child size tables and chairs for snack and activities. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. The napping room had cots in good condition and each child have their separate blankets. Licensee states there are no guns or weapons of any kind in the home. There are three pets in the home. The outdoor play area is fenced and safety gates put in place around the yard to prevent access to children in unwanted areas. Licensee and helper have valid CPR. Licensee provides daily snacks and meals. Discipline policy is redirection. LPA reviewed children’s files. All required postings are properly posted.

see next page...
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/01/2023
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: ARMENTA, MONICA
FACILITY NUMBER: 015700335
VISIT DATE: 03/01/2023
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During Inspection, 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.



Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

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.

Three Technical Violations were given during the inspection, please see LIC9102 for Technical Violations.

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

Exit interview conducted and report was reviewed with the facility representative, Monica Armenta

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC809 (FAS) - (06/04)
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