<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 354415994
Report Date: 05/04/2021
Date Signed: 05/04/2021 01:54:05 PM

Document Has Been Signed on 05/04/2021 01:54 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:RAMOS, RITAFACILITY NUMBER:
354415994
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 1DATE:
05/04/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Rita RamosTIME COMPLETED:
01:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Deanna Villagrana met with applicant Rita Ramos to conduct an announced change of location inspection Via Facetime due to Covid-19. The adults that reside in the home are the Applicant, her husband, adult son and two minor daughters ages 15 and 14 years old. Applicant's one year old grandson was present during the visit. He does not live in the home.

Days and hours of operation will be Monday - Friday from 6:30 AM to 6:00 PM. Applicant has completed her Preventative Health and Safety Child Care Training including Lead training on 04/06/2021. A copy of the certificate is on file. Applicant's CPR and First Aid certifications are current and expire on 07/14/2021. Applicant completed Mandated Reporter training on 01/27/2018. Applicant's owns the home. Applicant has liability insurance with Acord and it expires on 07/30/2021.

LPA toured the indoor and outdoor areas during today's visit. LPA observed a barricaded fireplace in the family room. Off limit areas inside the home: Master bedroom/bath, two bedrooms, one hallway closet, and attached garage. LPA observed a fully charged 3A40BC fire extinguisher, working combo smoke and carbon monoxide detector, fenced backyard, and no bodies of water. Off limit area in the backyard is the left side of the home that is fenced off to the children including a locked storage. Applicant states there are no animals in the home. Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. LPA reminded Applicant that smoking, baby walkers, bouncers, jumpers, and similar items are not allowed in Family Child Care Homes. There are no weapons in the home.

A review of staff records on 05/04/2021 indicates that not all Facility staff or other individuals who require caregiver background checks have received criminal record
and child abuse index clearances or exemptions. Licensee Rita Ramos fingerprint
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE: DATE: 05/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/04/2021
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: RAMOS, RITA
FACILITY NUMBER: 354415994
VISIT DATE: 05/04/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
clearance are pending. LPA reminded Applicant of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

Forms of discipline used by Applicant: talking to children and redirection. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed. LPA informed Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

A Family Child Care Home packet with updated Licensing forms was mailed to Applicant prior to visit and reviewed with the Applicant. LPA discussed the requirements of AB 633 with the Applicant and provided her the AB 633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and Applicant understands the requirements. LPA also discussed "zero tolerance" related regulations with the Applicant and advised her of the assessment of an immediate $500 civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected. 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. SB 792 Immunization Requirements was also discussed. Applicant's immunization records are on file.

LPA conducted an exit interview with the Applicant and advised her that a Small Family Child Care Home license is pending fingerprint clearance for applicant, mandated reporter training and Managers approval.

This report has been emailed to Applicant and Applicant will reply to email in lieu of a signature.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2