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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423489
Report Date: 07/23/2024
Date Signed: 07/23/2024 11:25:15 AM

Document Has Been Signed on 07/23/2024 11:25 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ROMERO, MELITONFACILITY NUMBER:
013423489
ADMINISTRATOR/
DIRECTOR:		ROMERO, MELITONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 963-0971
CITY:SAN LEANDROSTATE: CAZIP CODE:
94578
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
07/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Meliton RomeroTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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On July 23, 2024 at 8:45am, Licensing Program Analyst (LPA) Julia Placencia arrived at the facility unannounced to conduct an Annual/Random Inspection. LPA met with licensee Meliton Romero and his daughter Gloria Campos. Gloria served as translator as licensee's first language is Spanish. Also residing in the home is the licensee’s spouse Olivia Campos, son Antonio Campos, daughter Angelica Romero Campos, and 5 year old grandson. The facility is a one story single family home (duplex in front unit closest to street). Hours of operation for child care are Monday through Friday, 6:00am to 6:00pm. The following was observed during today’s inspection:

Capacity/Staffing: The facility operates as a Family Child Care Home (large), which may have a maximum capacity of twelve (12) to fourteen (14) children. At time of inspection, there were seven (7) children in care (one infant and six preschoolers). The facility is in compliance with ratio and capacity limitations.

ON Limit areas (accessible to children in care): Living Room, Kitchen/Dining Room, Hall Bathroom and Backyard. LPA observed the facility to be clean and in good repair, with heating and ventilation for safety and comfort. There were ample age appropriate toys that observed to be safe and in good condition. The wood burning fireplace had a child proof barricade. The backyard has a fence surrounding the perimeter of the yard. LPA observed a child's inflatable wading pool with a few inches of water that licensee emptied during LPA's visit. LIcensee is aware the pool must be emptied after each use. LPA did not observe any hazardous or toxic items accessible to children in the ON Limit areas of the facility today.

OFF Limit areas (not accessible to children in care): All Three Bedrooms including the Master Bathroom, and Garage. OFF Limit areas are inaccessible by closed and/or locked doors and visual supervision. Licensee is advised to contact Licensing so that an inspection can be completed prior to changing an OFF Limit area to ON Limit.



***Continued on LIC809-C...
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ROMERO, MELITON
FACILITY NUMBER: 013423489
VISIT DATE: 07/23/2024
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Emergency Preparedness/Safety: Facility has two fully charged 3A40BC fire extinguishers, one on wall in the living room near fireplace and the other in the backyard. Carbon monoxide/smoke detector combination unit on hallway ceiling was tested and found to be functioning. First aid supplies are available. A fire/disaster drill was last conducted on 2/6/24 and meets the six month requirement. Facility has phone service. Per licensee, there are no firearms in the home. Emergency Disaster Plan is current.

Staff Records Review: Licensee and all adults living and/or working in the home have proper criminal background clearances. Licensee, Olivia and Gloria have current CPR/First Aid training, which expires on 9/2025. Licensee’s mandated reporter training expires 1/30/25. Licensee and Gloria are in compliance with immunization law.

Children’s Records Review: Required licensing documents were observed. Licensee maintains an infant sleep log for infants up to 24 months. Liability Insurance Affidavits are children's files. A facility roster is maintained.

Licensing Posting (required): Facility license, Notification of Parents’ Rights, Earthquake Preparedness.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to [email protected]. 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.



Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 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.




***Continued on LIC809-C...
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ROMERO, MELITON
FACILITY NUMBER: 013423489
VISIT DATE: 07/23/2024
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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-andresources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing 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) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

There were no deficiencies cited during today’s inspection. Please see LIC 9102 for Advisory Notes.

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

Exit interview conducted and report was reviewed with the licensee Meliton Romero and daughter Gloria Campos.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
LIC809 (FAS) - (06/04)
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