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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274415554
Report Date: 08/11/2022
Date Signed: 08/18/2022 08:40:13 AM

Document Has Been Signed on 08/18/2022 08:40 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:FARFAN DE ZAMORA, CONSUELOFACILITY NUMBER:
274415554
ADMINISTRATOR:FARFAN DE ZAMORA, CONSUELOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 740-9198
CITY:ROYAL OAKSSTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
08/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Consuelo Farfan De ZamoraTIME COMPLETED:
04:30 PM
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 Licensing Program Analyst (LPA) Elizabeth Berumen met with Licensee, Consuelo Farfan De Zamora for an unannounced Required – 1 year annual inspection. LPA observed seven day care children (preschoolers) and Licensee's adult daughter (Brianna Zamora) in the home during today's inspection. The Licensee was operating within her capacity and ratio requirements during today's inspection. LPA observed the required postings, including the facility license, near the front entrance to the home. The home has a working cell phone number (831) 740-9198. Days and hours of operation are Monday - Friday from 6:00 AM to 6:00 PM. The Licensee and her spouse, Raul Zamora, her two adult children, Raul Zamora Jr and Brianna Zamora Farfan are the adults residing in the home. Licensee has a 17 year old daughter. Licensee's minor daughter will be 18 in March 2023. LPA reminded Licensee to have her fingerprinted after she turns 18 years old.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on August 9, 2022. Licensee has current CPR and First Aid certifications (expiration: 06/08/2024). Licensee has the required vaccines (MMR, Tdap, & immunization) and is current with her Mandated Reporter Training for Child Care Workers. LPA reviewed seven children's files and the files were complete with the required forms. LPA reviewed two staff files (Licensee & Assistant, Brianna Zamora) and the files were complete with the required forms. Licensee states that a child will be isolated away from other children in play room area if necessary due to illness or communicable disease.

LPA toured the indoor and outdoor areas of the home during today's inspection. The home is clean, orderly, (including central heating/ventilation), and safe for the day care children. There are safe and age appropriate toys, play equipment, and materials for the children in the home.

LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. The Licensee states that she does not have any weapons.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: FARFAN DE ZAMORA, CONSUELO
FACILITY NUMBER: 274415554
VISIT DATE: 08/11/2022
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All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. Any poisons are locked and inaccessible to the day care children. The Licensee states that she does not administer any medication to the day care children at this time. Licensee states that no one in the home smokes and she understands that smoking is prohibited in the home.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity/ratio options and she understands that she cannot have more than 14 children present in the home without at least two qualified adults present. Licensee states that does not transport any day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

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 the Licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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.

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/process

Exit interview conducted and report was reviewed with the Licensee, Maria Fernandez. No deficiencies issued during today's inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022
LIC809 (FAS) - (06/04)
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