274412949-8-13-2024-07-CC-ACOZ-D84VQ4-20240813163742

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274412949
Report Date: 08/13/2024
Date Signed: 08/13/2024 04:37:55 PM

Document Has Been Signed on 08/13/2024 04:37 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	JARA, GABRIELA		FACILITY NUMBER:	274412949
ADMINISTRATOR:	JARA, GABRIELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 392-7694
CITY:	SEASIDE	STATE: CA	ZIP CODE:	93955
CAPACITY:	14	CENSUS: 8	DATE:	08/13/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:05 PM
MET WITH:	Gabriela Jara		TIME COMPLETED:	04:45 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) Andrea Cortez conducted an unannounced Required - 1 Year Inspection (care tool). LPA was greeted and granted entrance by the Licensee Gabriela Jara. The purpose of today’s inspection is to ensure the home is in compliance with *Title 22 California Code of Regulations.* Todays census is 8, (2 infant, 6 preschool age). Also present during today's inspection were the Licensee's two assistants who are cleared and associated to the family child care home license. The Licensee her husband Eliseo Jara, adult son Octavio Jara, mother Sofia Perez, and father in law Juan Jara are the only adults who reside in the home. The day care hours of operation are Monday - Friday, 7:30am - 5:30pm. The Licensee's CPR and First Aid are current and expire November 2025. The Licensee's fees are current. LPA toured the indoor and outdoor areas of the home during today's visit. LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's visit. The last fire disaster drill was conducted on June 29 2024. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the children in care. The home is orderly, and safe for the day care children. The LPA observed a wall heater properly barricaded. Off limit areas of the home: the main house, family yard (completely gated), and garage. The Licensee has a designated separate space for the day care.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Andrea Cortez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: JARA, GABRIELA	FACILITY NUMBER: 274412949
	VISIT DATE: 08/13/2024

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
26
27
28
29
30
31
32

LPA observed a fully charged 2A10BC fire extinguisher, working smoke, and carbon monoxide detectors. LPA observed an above ground pool in the off limit family back yard. The family back yard is completely separate from the family child care home backyard space. There is no entrance from one yard to the other, the latter to the pool is still put away and inaccessible. The Licensee states that she does not have weapons in the home. All detergents, cleaning compounds, poisons, medications, and other similar items are out of reach and inaccessible to children. Licensee states that she does not administer medications at this time.

LPA observed staff immunization records on file.

LPA discussed the safe sleep regulations with the License 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.

LPA verified Sleep Log for both infants in care.

A review of staff records on August 13 2024 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 Gabriela Jara 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

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Andrea Cortez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024

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: JARA, GABRIELA	FACILITY NUMBER: 274412949
	VISIT DATE: 08/13/2024

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
26
27
28
29
30
31
32

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

The Licensee has completed the Mandated Reporter Training.

No deficiencies cited. Exit interview conducted and report was reviewed with the Licensee Gabriela Jara.

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

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Andrea Cortez	TELEPHONE: (916) 798-3658
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3