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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274411312
Report Date: 11/04/2021
Date Signed: 11/09/2021 01:36:59 PM

Document Has Been Signed on 11/09/2021 01:36 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:GONZALEZ, ROSA ELIAFACILITY NUMBER:
274411312
ADMINISTRATOR:GONZALEZ, ROSA ELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 768-8784
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
11/04/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Rosa Elia GonzalezTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Elizabeth Berumen conducted an unannounced annual/random inspection to the home. LPA met with Licensee's Assistant, Brenda Cabrera Ramirez who states Rosa Elia is at the store and will return soon. Present with Brenda were two day-care children (preschoolers). LPA explained the nature of today's inspection to Brenda. Licensee arrived shortly after and LPA explained the nature of the inspection to her. Days and hours of operation are Monday - Friday 6:00 AM to 6:00 PM and Saturday's 6:00 AM to 2:00 PM. The adults that reside in the home are Licensee, her partner (Jose Ramirez). Jose has TB test, LIC 508. Licensee has a 16 year old daughter that also lives in the home. Licensee states she has a new telephone number (831) 235-6296 home (831) 228-1873.
A review of staff records on November 2, 2021 indicates that all 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. Civil penalty amounts were discussed.

LPA reviewed Licensee and Assistant's (Brenda Cabrera Ramirez) file. Brenda has Tuberculosis (TB), immunization against influenza, measles and pertussis and CPR & First Aid, expiring 08/07/2023. Employee Rights (LIC 9052), LIC 508 and LIC 9108 are on file; Mandated Reporter Training was completed on 08/25/2021.

Licensee's certifications for CPR and First Aid are current and expire on 12/19/22. Licensee has immunization's against pertussis, measles and influenza. Licensee completed the Mandated Reporter Training on 02/25/20. Licensee understands that she is to complete the training every two years.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE: DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2021
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: GONZALEZ, ROSA ELIA
FACILITY NUMBER: 274411312
VISIT DATE: 11/04/2021
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LPA inspected the indoor and outdoor areas of the home that are used for day care.
Off limit areas in the home are bedroom 1, bedroom 2, bedroom 3, garage, living room, dining room and kitchen. The on-limit areas are recreation room, outside playground, and bathroom in recreation room. The home was approved for these areas on 02/12/21; The rooms have fire marshal approval dated 02/02/21. There is a fenced off area with a gazebo that is off limits to children. LPA observed that Licensee no longer has a playground structure. She states she removed it and is not using the grass gated area for day care. LPA notes that parents and children enter via the backyard area.

LPA reviewed Child Care Facility Roster. LPA reviewed the Fire/Disaster drill log, last drill conducted on 10/05/21. 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 observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detector, and no bodies of water. The Licensee states that she does not have any weapons in the home. Licensee has a pet dog; LPA reviewed vaccines/current shots. All detergents, cleaning compounds, and other similar items are stored in locked hallway closet inaccessible to children. Medication is stored in Licensee's off limit bedroom.

Supervision of children was discussed with Licensee and she understands that she must be present in the home during 80% of the day care hours and ensure that the children are supervised at all times. The Licensees understand her capacity options and understands that she can not have more than 14 children in the home at any time with a qualified adult present. Rosa Elia Gonzalez states that she does not transport children but understands that children are not to be left alone in vehicles.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

Licensee is encouraged to frequent the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of Laws, etc.
No deficiencies issued during today's inspection.

LPA conducted an exit interview with Licensee, Rosa Elia Gonzalez prior to the conclusion of today's inspection.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
LIC809 (FAS) - (06/04)
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