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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274409709
Report Date: 09/17/2019
Date Signed: 09/17/2019 12:18:13 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:HARO, ELIAZERFACILITY NUMBER:
274409709
ADMINISTRATOR:HARO, ELIAZERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 442-4106
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY:14CENSUS: 0DATE:
09/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Eliazer HaroTIME COMPLETED:
12:30 PM
NARRATIVE
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Licensing Program Analysts (LPA) Fermin Campos-Jaramillo conducted an unannounced annual random inspection to the home today. LPAs met with Eliazer Haro, 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 5:00 PM. Licensee stated she is the only adult residing in the home. There were not children in care at LPAs arrival. Licensee's certifications for CPR and First Aid card are current and will expire on 03/03/2020.

.LPA toured the indoor and outdoor areas of the home during today's inspection. LPA reviewed and took a picture of the Child Care Facility Roster during today's inspection and it is not current. Licensee has not performed a fire drill during the last six months. Last fire drill was documented on 4/12/2018. LPA reviewed 6 children's files and they are current and complete.
The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas inside are: Only the licensee's bedroom. Off limits areas outside: None, the home is located in a department complex and there is a small back patio that licensee uses as playground for the children in care. The home is located in a gated community and it is fenced.
LPAs observed a fully charged 3A40BC fire extinguishers that were last serviced on August 2019 and at least one working smoke detector. LPAs 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. LPA observed the home does not have a laundry area. Licensee stated the laundry is a common space out of the apartments and located in a different building within the premises of the complex. LPA observed a barricaded wall heater in the home. LPA discussed Incidental Medical Services (IMS) with the Licensee. Licensee has in file proof of having immunization for pertussis, influenza, and measles for herself, according with the SB792.

**********************************Report dated 09/17/2019 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: 09/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019
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: HARO, ELIAZER
FACILITY NUMBER: 274409709
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/01/2019
Section Cited

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Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This regulation was not met as evidenced by: Licensee did not have an updated roster available for review. Licensee understads this poses a potential risk to the health and safety of the children in care.
Type B
10/01/2019
Section Cited

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(A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.1. The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home.
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This regulation was not met as evidenced by: Licensee has not conducted and documented a fire drill since April 2018. Licensee understads this poses a potential risk to the health and safety of the 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: 09/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2019
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: HARO, ELIAZER
FACILITY NUMBER: 274409709
VISIT DATE: 09/17/2019
NARRATIVE
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*************************Report dated 09/17/2019 continues from page 1.

A review of staff records on 09/12/2019 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 in absence of a helper the capacity of her license is reduced in capacity and ratio to a small Family Child Care Home license, maximum 8, and ratio (age of the children) must be observed. 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 discussed the requirements of AB 633 whenever a Type A deficiency is cited. LPA also discussed "zero tolerance" related regulations with the Licensee. Licensee was advised of the required "mandated reporter" training that all Licensees will be required to complete starting January 1/01/2018. LPA referred the Licensee to the Department website: www.ccld.ca.gov and www.mandatedreporterca.com 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. 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.

Deficiencies (type B) were cited during today's inspection. Licensee rights form was printed and handed to Licensee both in English and Spanish. 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 SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3