274416031-5-10-2023-07-CC-SCES-CRPNNS-20230510103713

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274416031
Report Date: 05/10/2023
Date Signed: 05/10/2023 10:37:20 AM

Document Has Been Signed on 05/10/2023 10:37 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:	SANCHEZ, ALICIA		FACILITY NUMBER:	274416031
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	05/10/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Alicia Sanchez		TIME COMPLETED:	10:40 AM

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On 05/10/2023 at 9:55 AM, Licensing Program Analyst (LPA) Susy Cervantes met with licensee, Alicia Sanchez, for a case management visit to increase the capacity. Present during today's visit were licensee, their assistant/sister, and their daughter with five (5) children in care: two infants and three preschool. Adults living in the home are licensee with two children ages 17 and 11. Days and hours of operation are Monday through Friday 5:00 AM to 6:00 PM. A clearance from the Greenfield Fire Protection was submitted by licensee prior to today's visit, form has not been received by the fire department.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 05/18/2023 was reviewed and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. 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 inspected inside and outside of the home. An annual inspection had been conducted on 12/08/2022 and there were no deficiencies. LPA was informed that a fire pull station was not needed according to the Greenfield fire department. LPA observed a 3A40BC fire extinguisher that was serviced on 03/07/23. Carbon Monoxide detector and smoke detectors were operable. LPA observed licensee has CPR and First aid that expires on 09/18//2023. LPA reviewed with licensee FCCH large capacity/ratio requirements and children's documents.

Exit interview conducted and report was reviewed in Spanish with the licensee, Alicia Sanchez. LPA advised licensee that licensure for a large Family Child Care Home license is approved pending the following:

- Management's approval

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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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