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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274413675
Report Date: 01/30/2020
Date Signed: 01/30/2020 03:06:19 PM

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:REYES, LAURAFACILITY NUMBER:
274413675
ADMINISTRATOR:REYES, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 998-8788
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY:14CENSUS: 0DATE:
01/30/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Laura ReyesTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Susy Cervantes met with licensee Laura Reyes for an annual/random inspection and explained the nature of today’s visit. Present during today’s visit were Licensee with her seven year old son. Adults living in the home are Licensee, her husband Ramon and her daughter Kayla that is currently in University with one child age seven. Days and hours of operation are Monday through Saturday, 6:00 am to 6:00 pm.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 01/23/20 was reviewed; and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearance, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100 per person per day, minimum of $100 to a maximum of $500 per person for an initial violation, and a minimum of $100 to a maximum of $3000 per person for any subsequent violation within a 12-month period.

LPA toured the inside and outside of the home. LPA observed a covered fireplace and no wall heaters. LPA observed stairs without a barricade, Licensee is currently only providing care for school age children. Off limits indoor: second floor, laundry room, and attached garage. There are no bodies of water. Licensee stated there are no firearms/weapons in the home. LPA observed a 3A40BC fire extinguisher that was last serviced on 6/30/19. Smoke detector and Carbon Monoxide detectors are operable. LPA observed sufficient materials, toys, and play equipment for the children in care. Telephone is in working order. Sharp objects, medicines, poisons and cleaning supplies are inaccessible to the children. Backyard is fenced. There is a dog and Licensee showed proof of vaccination. Off limits outdoor: right side yard and locked shed.
Continues on report dated 01/30/2020
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy CervantesTELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
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: REYES, LAURA
FACILITY NUMBER: 274413675
VISIT DATE: 01/30/2020
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LPA reminded licensee that she can only have 14 children according to her license with a qualified assistant. LPA went over substitute options. Licensee stated that she does transport children, LPA reminded Licensee that children are never to be left in parked vehicles and must use appropriate car seats according to the child's age/weight/size.

LPA received a copy of a current roster of the children. LPA observed a fire and disaster drill log that was last conducted on 11/25/19. LPA reviewed three children’s files and observed a copy of the emergency information card (LIC 700) in each file. LPA observed that the Licensee and her husband/assistant have completed Mandated Reporter training on 6/17/19. Licensee has Pediatric CPR/1st Aid expiring 1/24/21. Licensee has all needed documentation for SB 792 which requires immunization against Pertussis, Measles, and Influenza as well as TB testing.

Incidental Medical Services (IMS) policy was discussed with the licensee. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The licensee is not providing IMS at this time. Licensee will submit an updated plan of operation if in the future they provide any IMS services to a child in care.

Licensee was reminded that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. LPA discussed the immediate civil penalties for Zero Tolerance of $500. Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility. Safe sleep was discussed with the Licensee and Guide to Safe Sleep information was provided to the licensee. Department website: http://ccld.ca.gov provided to Licensee.

Licensee was informed that failure to correct the deficiencies by the specified Plan of Correction Due Date may result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made. An exit interview was conducted with Licensee. No deficiencies are/were cited during today’s inspection. Notice of site visit must remain posted for 30 days.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy CervantesTELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020
LIC809 (FAS) - (06/04)
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