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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274412756
Report Date: 06/29/2023
Date Signed: 06/29/2023 12:03:38 PM


Document Has Been Signed on 06/29/2023 12:03 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:VALDEZ, LOURDESFACILITY NUMBER:
274412756
ADMINISTRATOR:VALDEZ, LOURDESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 728-6567
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 11DATE:
06/29/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Lourdes ValdezTIME COMPLETED:
12:10 PM
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Licensing Program Analysts (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection to the home today. LPA met with Lourdes Valdez, Licensee, and explained the nature of today's visit to her. LPA observed there were eleven children in care today, including three infants, one school age, and seven preschoolers. Licensee's helper Maria Castillo was helping with the supervision. Licensee's 17 years old daughter was also helping. Days and hours of operation are Monday to Saturday from 6:00 AM to 6:00 PM. The adults that reside in the home are the Licensee and her husband Israel. A 17 years old minor also resides in the home. Licensee's certifications for CPR and First Aid are current and will expire on 12/21/24 and on 6/22/24 for helper Maria.

LPA toured the indoor and outdoor areas of the home during today's visit. LPA obtained a copy of the children's roster. The last fire drill was documented on 5/15/23. LPA reviewed five children files and they are complete. Licensee has a working telephone 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 observed there is a barricaded wall heaters inside the home. Off limit areas in the home: Bedrooms #1 and #2. The home has a barricaded fireplace located in the on limits living room. There are not stairs in the home. Off limit areas outside the home: The front yard, the driveway to the left side of the home, the laundry room which is accessed by the drive way, and an storage shed at the far right corner of the back yard. The home has a fenced back yard which is used as playground and activities area.
LPA observed a fully charged 3A40BC fire extinguisher last time serviced on 2/08/23, working smoke and carbon monoxide detectors. The Licensee states that she does not have any weapons in the home. LPA observed there are not bodies of water. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. Licensee has in file proof of the immunization for measles, pertussis and influenza according with the SB792.

*******************************Report dated 6/29/23 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: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/29/2023
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: VALDEZ, LOURDES
FACILITY NUMBER: 274412756
VISIT DATE: 06/29/2023
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Report dated 6/29/23 continues from page 1.

Supervision of children was discussed with Licensee and Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time and ratio (age of the children) must be observed, and a helper must be present.
Licensee understands that in absence of a helper her license is automatically converted in capacity 8 and ratio must be observed as well. Licensee stated she does not transport 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 has renewed the Mandated Reporter training on 3/09/22 and her helper on 2/08/23. 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 6/20/23 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 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 webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource.

Report dated 6/29/23 continues in page 3

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
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: VALDEZ, LOURDES
FACILITY NUMBER: 274412756
VISIT DATE: 06/29/2023
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Report dated 6/29/23 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 Lourdes Valdez confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Exit interview conducted and report was reviewed with the licensee Lourdes Valdez in Spanish.No deficiencies were cited today.

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

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3