274412878-8-17-2022-07-CC-FCJO-CHDQQV-20220817122259

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274412878
Report Date: 08/17/2022
Date Signed: 08/17/2022 12:23:10 PM

Document Has Been Signed on 08/17/2022 12:23 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:	HERNANDEZ, ANGELICA		FACILITY NUMBER:	274412878
ADMINISTRATOR:	HERNANDEZ, ANGELICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 759-9383
CITY:	SALINAS	STATE: CA	ZIP CODE:	93905
CAPACITY:	14	CENSUS: 11	DATE:	08/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Angelica Hernandez		TIME COMPLETED:	12:40 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 Angelica Hernandez, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Friday from 3:00 AM to 11:00 PM, and Saturdays from 5:00 AM to 6:30 PM. The adults that reside in the home are the Licensee, her spouse Miguel, her sons Miguel and Gustavo. Licensee's helpers Miguel (spouse), and her son Miguel were present. LPA observed 11 children in care during today's inspection, included three infants and eight pre-school age. Licensee Certifications for CPR and First Aid card are current an will expire on 01/20/2024 for licensee and on 9/13/23 for her helper Miguel. LPA toured the indoor and outdoor areas of the home during today's inspection. LPA obtained a copy of children's roster and it is current. Licensee has documented a fire drill during the last six months. Last fire drill was documented on 7/07/22. LPA reviewed 14 children's files and observed that parent's rights forms, immunization records forms, consents for emergency medical treatment forms, and Identification and emergency information forms are in each file. 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: All the second floor and the laundry area and the garage in the first floor. LPA observed there are barricaded stairs in the home. The home has a fireplace and it is barricaded. Off limits areas outside: The right side yard. LPA observed the back yard is fenced. Licensee uses the back yard as playground whenever the weather allows it. LPA observed a fully charged 3A40BC fire extinguisher last time services on 6/23/22 and working smoke detectors. LPA observed the home has at least one working carbon monoxide detector and no bodies of water. The Licensee states that she does not have any weapons in the home. LPA reminded licensee that all detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. **************Report dated 8/17/22 continues on 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: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

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: HERNANDEZ, ANGELICA	FACILITY NUMBER: 274412878
	VISIT DATE: 08/17/2022

NARRATIVE

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***********Report dated 8/17/22 continues from page 1.

Licensee has in file proof of having immunization for measles, pertussis and influenza for herself and for her helpers.
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 whenever there are more than 8 children in care. Licensee understands that her license's capacity is reduced to only 8 if a helper is not present in the home, and ratio must be observed. The Licensee states that her spouse and helper transports children via vehicle and they understand 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 with the Licensee. LPA also discussed "zero tolerance" related regulations with the Licensee.
Licensee's mandated reporter training was renewed on 8/11/21 for herself and for her two helpers, spouse Miguel and son Miguel. Licensee understands the training shall be renewed every two years and it is now available in Spanish. LPA referred the Licensee to the Department website: www.mandatedreporterca.com for additional information on the online training.

A review of staff records on 8/09/22 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 Angelica Hernandez was 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.

Report dated 8/17/22 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: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

LIC809 (FAS) - (06/04)

Page: 3 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: HERNANDEZ, ANGELICA	FACILITY NUMBER: 274412878
	VISIT DATE: 08/17/2022

NARRATIVE

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Report dated 8/17/22 continuers from page 2.

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.

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 licensee Angelica Hernandez

There were not deficiencies 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: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

LIC809 (FAS) - (06/04)

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