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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274403160
Report Date: 11/15/2019
Date Signed: 11/15/2019 11:19:26 AM

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:MARQUEZ, AMALIAFACILITY NUMBER:
274403160
ADMINISTRATOR:MARQUEZ, AMALIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 633-0413
CITY:CASTROVILLESTATE: CAZIP CODE:
95012
CAPACITY:14CENSUS: 9DATE:
11/15/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Amalia MarquezTIME COMPLETED:
11:25 AM
NARRATIVE
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Licensing Program Analyst (LPA) Fermin Campos-Jaramillo conducted an unannounced annual random inspection to the home today. LPA met with Amalia Marquez, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday-Friday from 6:00 AM to 6:00 PM and Saturday 6:00 AM to 2:00 PM The adults that reside in the home are the Licensee, her spouse Art, her mother Amalia (who is also her helper), her adult daughters Kimberly and Yesenia, and her adult son Ernesto. Present in today's inspection were nine children in care included one infant and eight preschoolers. Present also in the home was Licensee's helpers Amalia Padilla and Yesenia Marquez. Licensee's and Yesenia's certifications for CPR and First Aid are current and will expire on 11/25/2021.
LPA toured the indoor areas of the home during today's inspection. LPA obtained a copy of the Child Care Facility Roster during today's inspection and it is current. LPA reviewed the Fire/Disaster drill log during today's visit. Last fire drill was documented on 10/31/19. LPA reviewed 5 children's files and are complete including a Parent's Rights form and the immunization records form. Licensee has a working telephone (landline) in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. LPA observed the home has central A/C and heating. Off limit areas in the home are the three bedrooms, the master bathroom which is in the master bathroom and the licensee's office. The home has a converted garage which is been used as the main living room in the home. The home washing and dryer area is also located in the garage. There are no stairs in the home.
LPA observed a fully charged 3A40BC fire extinguisher last serviced May 2019, working smoke and carbon monoxide detectors and no bodies of water. 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 IMS with the Licensee. Licensee has in file immunization records for pertussis, measles, and flu vaccines for herself and for her helper according with the SB792.
A review of staff records on 11/13/19 indicates that all adults residing in the home or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Report dated 11/15/2019 continues in page 2.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
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 3
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: MARQUEZ, AMALIA
FACILITY NUMBER: 274403160
VISIT DATE: 11/15/2019
NARRATIVE
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Report dated 11/15/2019 continues from page 1.

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 qualified assistant must be present. The Licensee states that she transports children via vehicle and she understands that children cannot be left in parked vehicles unattended at any time.

Department website: www.ccld.ca.gov provided to Licensee.

LPA discussed the requirements of AB 633 with the Licensee. LPA also discussed "zero tolerance" related regulations with the Licensee.
LPA observed that licensee and her helpers have not renewed the "Mandated Reporter" training that all Licensees and adults in contact with children are required to take in accordance with the AB1207, their training certificates have expired on 10/20/2019. Licensee was informed that failure to correct the deficiencies by the specified Plan of Correction Due Date may result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made.
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. LPA provided licensee with a Child Care Advocate email: rwillia1@dss.ca.gov

There is a type B deficiency cited with today's inspection. Appeal rights was printed and given to Licensee. Exit interview and inspection 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 SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MARQUEZ, AMALIA
FACILITY NUMBER: 274403160
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/30/2019
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated
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reporter training every two years following the date on which he or she completed the initial mandated reporter training. This regulation was not met as evidenced by: Licensee and her helpers's certification of compliance for the Mandated Reporter training have expired on 10/20/2019. This poses a potential risk to the safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2019
LIC809 (FAS) - (06/04)
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