274411528-11-21-2022-07-CC-FCJO-CLDV82-20221121151200

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274411528
Report Date: 11/21/2022
Date Signed: 11/21/2022 03:12:07 PM

Document Has Been Signed on 11/21/2022 03:12 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:	ZAMORA, MARIA		FACILITY NUMBER:	274411528
ADMINISTRATOR:	ZAMORA, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 228-9848
CITY:	SALINAS	STATE: CA	ZIP CODE:	93905
CAPACITY:	14	CENSUS: 8	DATE:	11/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Maria Zamora		TIME COMPLETED:	03:20 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 Analyst (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection to the home today. LPA met with Maria Zamora, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Saturday from 5:30 AM to 6:00 PM. The adults that reside in the home are the Licensee, her spouse Alberto, and three adult tenants: Beatriz, Librado, and Ynes. Also in the home resides a 17 years old minor tenant sister of Ynes.. LPA observed there were eight children in care today, included five preschool age, two infants, and one school age. Certification for CPR and First Aid Card for Licensee and her helper and spouse Alberto are current and will expire on 2/06/2024 and 5/03/23 respectively. LPA toured the indoor and outdoor areas of the home during today's inspection. LPA obtained a copy of the children's roster today and it is current. LPA reviewed five children files and observed files are complete, including the immunization records form and the parent's rights form. Licensee documented last fire drill on 10/01/22.. 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: All the second floor, and in the first floor, the laundry room, and the attached garage. Off limits areas outside: The back yard. The home has a left side yard and it is fenced, Licensee uses it as playground. LPA observed a fully charged 3A40BC fire extinguisher last time serviced on 7/12/22 and at least one working smoke detector. LPA observed the home has a carbon monoxide detector. LPA observed there are barricaded stairs in the home. LPA observed the home does not have wall heaters, or bodies of water. LPA observed the home has a barricaded fireplace. Licensee stated she does not have weapons. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. According with the SB792, Licensee has proof of immunization for herself and for her helpers for pertussis, measles, and influenza. *******************Report dated 11/21/22 continues in page 2

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2022

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: ZAMORA, MARIA	FACILITY NUMBER: 274411528
	VISIT DATE: 11/21/2022

NARRATIVE

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****************Report dated 11/21/22 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. Licensee understands children under the age of ten years old count as part of the capacity of her license. The Licensee states her spouse transports children via vehicle and that he 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.
LPA observed that the Licensee and her helper have renewed the "Mandated Reporter" training on 3/18/22 and was advised that all adults in contact with children are required to complete the "mandated reporter" training, and to renew the training every two years. LPA referred the Licensee to the training website: www.mandatedreporterca,com for additional information on the online training.

A review of staff records on 1/17/22 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 Maria 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. 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.

Report dated 11/21/22 continues on page 3.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2022

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: ZAMORA, MARIA	FACILITY NUMBER: 274411528
	VISIT DATE: 11/21/2022

NARRATIVE

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Report dated 11/21/22 continues from page 2.

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 Maria Zamora

No deficiencies were cited today.

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

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo	TELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2022

LIC809 (FAS) - (06/04)

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