274402986-7-9-2019-07-CC-FCJO-BDWS89-20190709133845

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274402986
Report Date: 07/09/2019
Date Signed: 07/09/2019 01:38:49 PM

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:	SALAZAR, MIROSLAVA, SAUL & MIRSA DE LA ROSA		FACILITY NUMBER:	274402986
ADMINISTRATOR:	SALAZAR, MIROSLAVA & SAUL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 676-3413
CITY:	SALINAS	STATE: CA	ZIP CODE:	93907
CAPACITY:	14	CENSUS: 7	DATE:	07/09/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Miroslava Salazar		TIME COMPLETED:	01:50 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) Fermin Campos-Jaramillo conducted an unannounced annual random inspection to the home today. LPA met with Miroslava Salazar, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Friday from 6:00 AM to 6:00 PM. Co Licensee Mirsa was also present in the home. The adults that reside in the home are the licensee, her daughter Mirsa who is also Licensee, Mirsa's spouse Marco, and Miroslava's spouse Saul. Also in the home resides Miroslava's 10 years old grandson. There were 7 children in care today included two infants, and five preschool age. Miroslava's and Mirsa's certification for CPR and First Aid Card are current and will expire on 7/14/2020 for both of them. LPA toured the indoor and outdoor areas of the home during today's inspection. LPA obtained a copy of the children's roster today and it is current. LPA randomly reviewed five children files and they are complete. Licensee has performed a fire drill during the last six months. Last fire drill was documented on 6/04/2019. The Licensee has a working telephone in the home (landline). LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas inside are: 3 bedrooms, the attached garage, and one bathroom. Off limits areas outside: The two side yards. The home has a back yard and it is fenced and used as playground. LPA observed a fully charged 2A10BC fire extinguisher and at least one working smoke detector. LPA observed the home has a working carbon monoxide detector. LPA observed there are not stairs in the home. LPA observed a barricaded fireplace in the home. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. LPA discussed Incidental Medical Services with licensee. According with the SB792, Miroslava and Mirsa showed they have immunization for measles, and pertussis and the opt out statements for influenza are in their personnel file. *******************************Report dated 07/09/2019 continues in page 2.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2019

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SALAZAR, MIROSLAVA, SAUL & MIRSA DE LA ROSA	FACILITY NUMBER: 274402986
	VISIT DATE: 07/09/2019

NARRATIVE

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Report dated 07/09/2019 continues from page 1.

A review of staff records on 07/03//2019 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also reminded Licensee 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.
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. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time and a helper must be present. Licensees understand in absence of a helper the capacity of her license is reduced in capacity and ratio to a small Family Child Care Home license (maximum 8) and ratio (age of the children) must be observed. The Licensee states that they do not transport children via vehicle and that they understand that children cannot be left in parked vehicles unattended at any time. Licensee uses redirection and communication with children as a form of discipline.
Department website: www.ccld.ca.gov provided to Licensee.
LPA discussed the requirements of AB 633 whenever a Type A deficiency is cited. LPA also discussed "zero tolerance" related regulations with the Licensee.
LPA observed that Licensee and her helper have already taken the Mandated Reporter Training on 11/29/2018 and 11/30/2017 respectively. LPA referred the Licensee to the Department website: www.ccld.ca.gov for additional information on the online training. LPA advised licensee of the pending Department regulation update re: Safe sleep for infant children. LPA referred the Licensee to the Department website: www.ccld.ca.gov for additional information.
There were no deficiencies cited during today's inspection. Appeal rights was printed and given to Licensee. Exit interview was conducted with licensee in Spanish.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2019

LIC809 (FAS) - (06/04)

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