274405087-6-4-2019-07-CC-FCJO-BCTSUB-20190604141051

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274405087
Report Date: 06/04/2019
Date Signed: 06/04/2019 02:10:56 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:	ORTIZ, MARIA & ROCHA, JOSE		FACILITY NUMBER:	274405087
ADMINISTRATOR:	ORTIZ, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 633-8721
CITY:	CASTROVILLE	STATE: CA	ZIP CODE:	95012
CAPACITY:	14	CENSUS: 8	DATE:	06/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Maria Ortiz		TIME COMPLETED:	02:20 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 Maria Ortiz, 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. and Saturdays from 6:00 AM to 2:00 PM. The adults that reside in the home are the licensees Maria and Jose. There were eight preschool children in care during today's inspection. Licensees' certifications for CPR and First Aid are current and will expire on 01/13/2020 for both licensees. 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 reviewed a random sample of five children's files and they are complete. LPA reviewed the Fire/Disaster drill log during today's visit and it is current. Last fire drill was documented on 5/31/2019. Licensee understand a fire drill shall be performed and documented at least one every six months. 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 inside are: 3 bedrooms, 1 bathroom and the attached garage converted into a living room. LPA observed there are no stairs in the home. The home has a fireplace which is barricaded. The off limits area outside the home is a shed in the backyard and the left side yard. LPA observed the home has a back yard and it is fenced. Licensees use the back yard and the right side yard as playground when the weather is good. LPA observed a fully charged 3A40BC fire extinguisher, working smoke detectors and no bodies of water. LPA observed the home has at least one 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. Licensees have submitted before proof of having immunization for measles, pertussis for both of them and a signed opt out statement for influenza for both licensees. ***************************Report dated 06/04/2019 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: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

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: ORTIZ, MARIA & ROCHA, JOSE	FACILITY NUMBER: 274405087
	VISIT DATE: 06/04/2019

NARRATIVE

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Report dated 06/04/2019 continues from page 1.
A review of staff records on 05/30/2019 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 Licensees understand their capacity options and they understand that they cannot have more than 14 children in the home at any time and a helper must be present. Maria understands that in absence of a helper her license capacity is reduced to only 8 children, and ratio (age of the children) must be observed. The Licensees stated that they do not transport children via vehicle and they understand 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 Licensees. LPA also discussed "zero tolerance" related regulations with the Licensee.
Licensees have proof of completion of the required "mandated reporter" training that all Licensees will be required to complete starting January 1, 2018. Licensees completed the training on 10/24/2017. LPA referred the Licensee to the Department website: www.ccld.ca.gov for additional information on the online training. LPA advised licensee Maria 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 not deficiencies cited during today's inspection. Licensee rights form was printed and given to Licensee. Exit interview was conducted with licensee Maria 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: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

LIC809 (FAS) - (06/04)

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