274405077-7-1-2019-07-CC-FCJO-BDNPR9-20190701113223

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274405077
Report Date: 07/01/2019
Date Signed: 07/01/2019 11:32:29 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:	VARGAS, MARIA		FACILITY NUMBER:	274405077
ADMINISTRATOR:	VARGAS, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 442-1980
CITY:	SALINAS	STATE: CA	ZIP CODE:	93906
CAPACITY:	14	CENSUS: 8	DATE:	07/01/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Maria Vargas		TIME COMPLETED:	11:40 AM

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 Maria Vargas, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Saturday from 5:00 AM to 6:00 PM. The adults that reside in the home are the Licensee, her daughter Lourdes (helper), her son Armando (helper), and her spouse Armando. There were 8 children in care during today's inspection included 3 infants and 5 preschool age. Licensee's and Licensee's helper, Lourdes, certifications for CPR and First Aid card are current an will expire on 02/02/2021. LPA toured the indoor and outdoor 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. Licensee documented a fire drill during last six months. Last fire drill was documented on 5/22/2019. Licensee understands a fire drill shall be performed and documented at least one every six months. LPA reviewed six children's files and observed that parent's rights forms, immunization records forms, consents for emergency medical treatment forms, and Identification and emergency information forms are in each file. The Licensee has a working telephone (landline) in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas are: 3 bedrooms and one bathroom. LPA observed there are not stairs in the home. The home does not have a fireplace neither has wall heaters. The off limits area outside the home is the detached garage and the left side of the back yard. LPA observed the home has a back yard and it is fenced. Licensee uses the back yard as playground when the weather is fine. LPA observed a size 3A40BC fire extinguisher, working smoke detectors and no bodies of water. LPA observed the home has at least one working carbon monoxide detector. 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 (IMS) with the Licensee. Report dated 07/01/2019 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: 07/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019

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: VARGAS, MARIA	FACILITY NUMBER: 274405077
	VISIT DATE: 07/01/2019

NARRATIVE

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Report dated 07/01/2019 continues from page 1.
LPA observed that the Licensee and her helper have in file proof of immunization for pertussis, measles, and influenza (required per SB792).
A review of staff records on 06/24/2019 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. Licensee understands that in absence of a helper the capacity of her license is reduced to 8 children only and ratio (age of the children) must be observed. The Licensee states that she does not transport children via vehicle and she understands 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 with the Licensee. LPA also discussed "zero tolerance" related regulations with the Licensee.
LPA observed that Licensee and her helper have completed the mandated reporter training on 1/17/2019 and 2/28/2019 respectively. Licensee understands that all the adults in contact with children shall complete the mandated reporter training as well. 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.

No deficiencies were 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: 07/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019

LIC809 (FAS) - (06/04)

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