274409709-11-13-2023-07-CC-FCJO-CXJQWP-20231113113215

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274409709
Report Date: 11/13/2023
Date Signed: 11/13/2023 11:32:22 AM

Document Has Been Signed on 11/13/2023 11:32 AM - 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:	PULIDO HARO, ELIAZER		FACILITY NUMBER:	274409709
ADMINISTRATOR:	PULIDO HARO, ELIAZER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 442-4106
CITY:	SALINAS	STATE: CA	ZIP CODE:	93905
CAPACITY:	14	CENSUS: 2	DATE:	11/13/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Eliazer Pulido		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 Analysts (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection to the home today. LPA met with Eliazer Pulido Haro, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Sunday from 5:00 AM to 5:00 PM. Licensee stated she is the only adult residing in the home. LPA observed there were two preschool age children present during the inspection. Licensee's certifications for pediatric CPR and First Aid are current and expiring on 3/17/24, and for her helper Guillermo 9/17/24. LPA toured the indoor and outdoor areas of the home during today's inspection. LPA obtained a copy of the children's roster. LPA observed that a fire drill was documented on 7/14/23. LPA reviewed five children's files and are complete including a Parent's Rights form and the immunization records form. 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 licensee stated she uses the common areas as playground for the children in care. LPA advised licensee to supervise the children all the time they are outdoors. The home is located in a gated community and it is fenced. LPA observed a fully charged 3A40BC fire extinguisher and at least one working smoke/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 now has a laundry area which is located in a closet by the hallway. LPA observed the detergents are stored inaccessible to the children in care. LPA observed a barricaded wall heater in the home. Licensee has in file proof of having immunization for pertussis, influenza, and measles for herself, according with the SB792. *************************Report dated 11/13/23 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: 11/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2023

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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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: PULIDO HARO, ELIAZER	FACILITY NUMBER: 274409709
	VISIT DATE: 11/13/2023

NARRATIVE

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*************************Report dated 11/13/23 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. 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 must be observed. Licensee states that her helper Guillermo 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.

Licensee has renewed the mandated reporter training on 6/13/22 and helper Guillermo on 1/05/23
Training website www.mandatedreporterca.com was provided for additional information on the online training. Licensee understands that the training is mandatory for all the adults in contact with the children in care.

A review of staff records on 11/07/23 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 was reminded that all the adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days 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-andresources/safe-sleep as an additional resource.

Report dated 11/13/23 continues in 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: 11/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2023

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: PULIDO HARO, ELIAZER	FACILITY NUMBER: 274409709
	VISIT DATE: 11/13/2023

NARRATIVE

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**************Report dated 11/13/23 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 PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Eliazer Pulido Haro confirmed that there are no Registered Sex Offenders living in the facility.

Exit interview conducted and report was reviewed with the licensee Eliazer Pulido Haro.
There were not deficiencies cited today.

A notice of site visit was handed to licensee 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: 11/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2023

LIC809 (FAS) - (06/04)

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