274408177-6-27-2024-07-CC-FCJO-D6MU9X-20240627152351

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274408177
Report Date: 06/27/2024
Date Signed: 06/27/2024 03:23:57 PM

Document Has Been Signed on 06/27/2024 03:23 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	ZAMORA, PATRICIA		FACILITY NUMBER:	274408177
ADMINISTRATOR:	ZAMORA, PATRICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 758-9035
CITY:	SALINAS	STATE: CA	ZIP CODE:	93905
CAPACITY:	14	CENSUS: 6	DATE:	06/27/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:55 PM
MET WITH:	Patricia Zamora		TIME COMPLETED:	03:40 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 Analysts (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection to the home today. LPA met with Patricia Zamora, Licensee, and explained the nature of today's visit to her. LPA observed six children were present in care during the inspection, included one infant, 4 preschoolers, and one school age. Also present was licensee's husband and helper Javier. Days and hours of operation are Monday to Friday from 6:00 AM to 5:30 PM and Saturdays 6:00 AM to 4:00 PM. The adults that reside in the home are the Licensee, her husband Javier and her adult children Javier and Daniel. Patricia's certifications for CPR and First Aid are current and expire in 03/22/25 and for Javier Rocha expires on 03/03/26. LPA toured the indoor and outdoor areas of the home during today's visit. LPA took pictures of the children's roster. Licensee has documented a fire/disaster drill on 4/05/23. LPA reviewed five children's file and they are complete. The Licensee has a working telephone (landline) in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is clean, orderly, and safe for the day care children. LPA did not observe any wall heaters inside the home. Off limit areas in the home: All second floor, and in the first floor: The master bedroom, one bathroom, the laundry room, and the attached garage. The home has a fireplace located in the on limits area. The fireplace is barricaded with a bookcase. There are barricaded stairs in the home. Off limit areas outside the home: One storage shed in the back yard and a section of the left side yard where the licensee keeps an small dog. Licensee Patricia stated the dog has been vaccinated. LPA observed a fully charged 2A10BC fire extinguisher last time serviced on 7/14/23, working smoke and carbon monoxide detectors. 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. Both licensee and her husband have proof of the immunization for measles, pertussis and influenza according with the SB792. *********************************Report dated 6/27/24 continues in page 2.

SUPERVISOR'S NAME: Susy Cervantes	TELEPHONE: (408) -32-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ZAMORA, PATRICIA	FACILITY NUMBER: 274408177
	VISIT DATE: 06/27/2024

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
26
27
28
29
30
31
32

Report dated 6/27/24 continues from page 1.

Supervision of children was discussed with Licensee and she understands that she or a qualified adult 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. Licensee understands in absence of a helper her license capacity is reduced to 8 and ratio (age of the children) must be observed. Licensee stated her husband Javier Rocha transports children via vehicle and he understands that children cannot be left in parked vehicles unattended at any time.
Department website: www.ccld.ca.gov provided to Licensees.

LPA observed that Licensee Patricia and her husband Javier have renewed the required "mandated reporter" training (AB1207) on 2/27/23 and 4/04/23 respectively. LPA informed licensee that all the adults in contact with children in her home are required to complete the training. LPA referred the Licensee to the training website: www.mandatedreporterca.com for additional information on the online training.

A review of staff records on 6/18/24 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 Patricia Zamora 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 6/27/24 continues on page 3.

SUPERVISOR'S NAME: Susy Cervantes	TELEPHONE: (408) -32-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ZAMORA, PATRICIA	FACILITY NUMBER: 274408177
	VISIT DATE: 06/27/2024

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
26
27
28
29
30
31
32

Report dated 6/27/24 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 Patricia Zamora in Spanish.

No deficiencies were cited today.

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

SUPERVISOR'S NAME: Susy Cervantes	TELEPHONE: (408) -32-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3