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Department of
SOCIAL SERVICES
FACILITY EVALUATION REPORT
Report Date:02/13/2024
Date Signed:02/13/2024 03:46:59 PM
Document Has Been Signed on 02/13/2024 03:46 PM - It Cannot Be Edited
This report must be available at Child Care and Group Home facilities for public review for 3 years.
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
414004994Report Date:02/13/2024
Date Signed:02/13/2024 03:46:59 PM
Document Has Been Signed on 02/13/2024 03:46 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 SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360 SAN BRUNO, CA 94066 |
| FACILITY NAME: | ALVARADO, DELPHINA SUAZO | FACILITY NUMBER: | 414004994 | |
| ADMINISTRATOR: |  | FACILITY TYPE: | 810 | |
| ADDRESS: | | TELEPHONE: | | |
| CITY: | | STATE: | ZIP CODE: | |
| CAPACITY: | 8 | CENSUS: 0 | DATE: | 02/13/2024 |
| TYPE OF VISIT: | Prelicensing | UNANNOUNCED | TIME BEGAN: | 12:45 PM |
| MET WITH: | Delphina Alvarado Suazo | TIME COMPLETED: | 03:55 PM | |
NARRATIVE | ||
1 | On 2/13/2024 at 12:45PM., Licensing Program Analyst (LPA), Luis Gomez met with Applicant, Delphina Alvarado Suazo. The purpose of inspection was explained and was for an Announced; Prelicensing inspection. Present during inspection was the applicant and no children. Adults living in the home have their criminal record clearances on file. Applicant’s home is a 4 bedroom, 2 bathroom, 2 level house. The days and hours of operations are: Monday- Friday, 8:00AM.- 5:00PM. The areas of the home designated for childcare are: First Level: Front Patio (Playroom); Living Room; Kitchen; Bathroom #1; Backyard and Front Yard. The areas of the home designated as off-limit are: First Level: Bedroom #1; Bedroom #2; Bedroom #3 (Pass through only); Bathroom #2; 2nd Level : Bedroom #4; and Storage. LPA inspected home with applicant for health and safety hazards.At 12:50PM., the following was observed: Home was clean and orderly, with age-appropriate playthings. Accessible furniture, toys, and books inspected were in good repair. Fireplace in living room had been properly barricaded. LPA observed storage cubbies for children’s belongings. Cabinets in the facility kitchen have safety locks installed. Bathroom #1 was clean, with adequate supplies for hand washing. The off-limit areas of the home have been made inaccessible. Home was a comfortable temperature with adequate ventilation and lighting. The detergents; toxins; cleaning compounds; and other items (which could pose a danger) are stored in the off-limit areas. Home has a cell phone; functioning smoke detector; and a fire extinguisher (3A40BC). LPA inspected applicant’s backyard and front yard area. Outside areas were enclosed with tall fencing. The tricycles and toys inspected were in proper repair. The applicant’s backyard was equipped with several movable climbing structures, and rubber padding for safety. LPA reviewed applicant’s storage shed during inspection. Home does not have any pools, jacuzzi, fishponds, or other bodies of water.At 1:35PM., LPA reviewed with applicant, the LIC311D, Records to Keep in Your Family Child Care Home, Children's Forms/ Records; Facility Forms/Records; and Information to be Posted. (REFER TO 809c, FOR CONT.) | |
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| I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. | ||||||
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| LIC809 (FAS) - (06/04) | Page: 1 of 3 |
| STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT (Cont) | CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360 SAN BRUNO, CA 94066 |
| FACILITY NAME: ALVARADO, DELPHINA SUAZO | FACILITY NUMBER: 414004994 |
| VISIT DATE: 02/13/2024 |
NARRATIVE | |
1 | (PAGE 2) Applicant’s Cardiopulmonary Resuscitation / First Aid certification was current, expiring: 2/2025. Applicant’s Mandated Reporter Training Certification (AB1207) was current, expiring: 2/12/2025. Per Applicant, isolation of an ill child will be in the Living Room. Per Applicant, home does not have any firearms or weapons. Applicant was informed that the Department must be notified prior to the use of designated off-limits areas. LPA and the applicant discussed licensing regulations and the capacity requirements. Any children under 10 years of age will be counted in the capacity. Applicant advised that all food containers brought from home must be properly stored and labeled. Applicant understands the required emergency disaster drills are to be conducted and documented every six months. Applicant understands that the use baby walkers, bouncers, jumpers and similar items are not to be used for children in care. Smoking is prohibited inside of a Family Childcare Home. Applicant was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility, unless he or she has been immunized for influenza, pertussis and measles or qualifies for an exemption pursuant to Health and Safety Code 1596.7995 and 1597.662.Applicant was reminded that all adults 18 years and over living in the home, person who provides care and supervision to children, and staff who have contact with children, including employee and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain criminal 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated. LPA and the applicant discussed the safe sleep regulations with licensee and discussed Child Care Licensing Safe Sleep Web page at:https://www.cdss.ca.gov/inforesource/child-care-licesning/public-information-and-resources/safe-sleep as an additional resource. LPA informed licensee of the importance of checking for recalled infant devices on United States consumer Product Safety Commission (CPSC) website at http://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. (REFER TO 809c, FOR CONT.) |
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| I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. | ||||||
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| LIC809 (FAS) - (06/04) | Page: 2 of 3 |
| STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY FACILITY EVALUATION REPORT (Cont) | CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360 SAN BRUNO, CA 94066 |
| FACILITY NAME: ALVARADO, DELPHINA SUAZO | FACILITY NUMBER: 414004994 |
| VISIT DATE: 02/13/2024 |
NARRATIVE | |
1 | (PAGE 3) On 2/13/2024, the California Attorney General – Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California’s Megan’s Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not be included in this search. However, the department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses, pursuant to information shared by California DOJ. Applicant was informed of the Mychildcareplan.org site, a consumer education website that helps families obtain childcare by connecting to childcare providers and resources and referral agencies (R&R) throughout California. Incidental Medical Services (IMS) policy was discussed. For IMS information, see PIN 20-02-CCP. When an IMS is provided, a plan for 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- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htmCommunity Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important communication platform. To receive important licensed- related information to licensed facilities, visit the CCLD important information website at https://www.cdss.ca.gov/infosource/community-care-licensing/subscribe and select the child care option to receive email communication. Prior to recommendation for licensure, applicant must complete the following: -Submit facility sketch, LIC999, of 2nd level-Submit proof of required immunization for adults in the home -Submit the LIC9217, Prelicensing Readiness Guide -Submit Proof of Control of Property -Post required posting in facility including: PUB394; LIC9148; and LIC610A -Obtain children’s napping supplies -Install Carbon Monoxide Detector (CO) -Complete Preventive Health and Safety Practices Course with Nutrition and Lead PreventionExit interview was conducted and report was reviewed with Applicant, Delphina Alvarado Suazo. This report will be kept in facility file and made available for public review upon request. Desk Duty is available Monday- Friday between 8AM - 5PM at (650) 266 -8800. |
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| I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. | ||||||
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| LIC809 (FAS) - (06/04) | Page: 3 of 3 |
