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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274407058
Report Date: 05/03/2023
Date Signed: 05/03/2023 12:14:11 PM


Document Has Been Signed on 05/03/2023 12:14 PM - It Cannot Be Edited

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:SAAVEDRA, ARACELIFACILITY NUMBER:
274407058
ADMINISTRATOR:SAAVEDRA, ARACELIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 633-0598
CITY:CASTROVILLESTATE: CAZIP CODE:
95012
CAPACITY:14CENSUS: 0DATE:
05/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Araceli SaavedraTIME COMPLETED:
12:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection to the home today. LPA met with Araceli Saavedra, Licensee, and explained the nature of today's inspection to her. LPA observed there were not children in care today, licensee stated she currently provides care to only two school age children. Licensee stated she works with the migrant program that runs from May to October only. Days and hours of operation are Monday to Saturday from 6:00 AM to 6:00 PM. The adults that reside in the home are the Licensee, her spouse Roberto, and her adult children Jose, Jessica, Ricardo, Carlos, and in law Veronica. Also in the home resides licensee's 8 year old grandson. Licensee's certifications for CPR and First Aid card is current and will expire on 8/20/24.
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LPA toured the indoor and outdoor areas of the home during today's inspection. LPA took a picture of the Child Care Facility Roster during today's inspection and it is current. LPA observed a fire drill was last documented on 5/20/21. 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: 4 bedrooms, one bathroom and the attached garage. Off limits areas outside: Right side yard and a storage shed in the back yard. Licensee keeps a mid-size dog in the right side yard. Licensee stated the dog is vaccinated. The home has a back yard and it is fenced. The licensee stated she uses the back yard as playground for the children in care.
LPA observed a fully charged 3A40BC fire extinguisher and a working smoke detector. LPA observed the home has a working carbon monoxide detector. LPA observed there are no bodies of water 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. Licensee has immunization on file for herself and her assistant Veronica.

Report dated 5/03/23 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: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
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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Document Has Been Signed on 05/03/2023 12:14 PM - It Cannot Be Edited

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: SAAVEDRA, ARACELI
FACILITY NUMBER: 274407058

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review the licensee did not comply with the section cited above, Licensee has not documented a fire/disaster drill since 5/20/21 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/17/2023
Plan of Correction
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Licensee shall conduct and document a fire/disaster drill, licensee will submit to Licensing Program a copy of the log not later than May 17, 2023.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day 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 reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above, Licensee has not renewed the training which expired on 11/04/20, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/17/2023
Plan of Correction
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Licensee Araceli shall renew the mandated reporter training (AB1207) for herself and for all the adults (included Veronica and Daniel) in contact with the children in care in her home. Licensee will submit a copy of the certificates of completion before or by May 17, 2023.
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: 05/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4


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: SAAVEDRA, ARACELI
FACILITY NUMBER: 274407058
VISIT DATE: 05/03/2023
NARRATIVE
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Report dated 5/03/23 continues from page 1.

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. Licensee understands that with a large Family Child Care Home license she can not provide care to more than 14 children at a time and a helper must be present. Licensee understands in absence of a helper the capacity of her license is downsized to only 8 children and ratio (children's age) must be observed in both cases. The Licensee states that she transports children via vehicle and that 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 observed that licensee has renewed the required "Mandated Reporter" training, AB1207 on 7/25/22 which is mandatory for licensees and all the adults in contact with children. Licensee understands the training shall be renewed every two years. LPA provided Licensee with the website address for additional information: www.mandatedreporterca.com

A review of staff records on 4/11/23 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Licensee Araceli Saavedra was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

***********************Report dated 5/03/23 continues on page 3.

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: SAAVEDRA, ARACELI
FACILITY NUMBER: 274407058
VISIT DATE: 05/03/2023
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Report dated 5/03/23 continues from page 2.

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 Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov. 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/process.


Exit interview conducted and report was reviewed with the licensee Araceli Saavedra in Spanish.

Two type B deficiencies were cited today.

Failure to comply with the Plan Of Corrections (POC) by the due date on LIC809D shall result in an immediate civil penalty of $100 per day per each deficiency.

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

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4