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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274415900
Report Date: 05/25/2022
Date Signed: 05/25/2022 10:44:03 AM


Document Has Been Signed on 05/25/2022 10:44 AM - 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:GARCIA, WENDYFACILITY NUMBER:
274415900
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
05/25/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Wendy GarciaTIME COMPLETED:
11:00 AM
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On 05/25/2022 at 09:55 AM, Licensing Program Analyst (LPA) Susy Cervantes met with licensee, Wendy Garcia for a case management to increase capacity. Present were licensee and their son with two preschool age children in care. Previous to today's visit, LPA received a Fire Clearance from the Salinas Fire Department, inspection was conducted on 05/20/2022.

An annual inspection was conducted on 01/12/2022, a type B deficiency was cited and was cleared on 01/13/2022. LPA observed a fire pull station near the main entrance and inspected the second exit for the home. LPA observed a new 3A40BC fire extinguisher, smoke detector and carbon monoxide detectors were operable. Licensee has current CPR and first aid that expires on 05/13/2023. Mandated Reporter training is current and was taken on 03/18/2022. LPA observed no fireplace, no stairs, no wall heater and no bodies of water. Licensee stated there are no weapons or pets in the home. LPA reviewed the requirements stated on the fire clearance with licensee, Wendy Garcia, including that the detached garage and storage sheds are not approved for use. LPA reviewed with licensee their ratio/capacity for a large FCCH as well as assistant requirement.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 05/24/2022 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. Licensee 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.

Continues on report dated 05/25/2022 _____________________________________pg. 1/2

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy CervantesTELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:
DATE: 05/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/25/2022
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 2


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: GARCIA, WENDY
FACILITY NUMBER: 274415900
VISIT DATE: 05/25/2022
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Continuation of report dated 05/25/2022 _____________________________________pg. 2/2

No deficiencies were cited during today's visit. Exit interview was conducted and report was reviewed in Spanish with Licensee, Wendy Garcia. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. A notice of site visit was given and must remain posted for 30 days.

LPA informed licensee that an increase of capacity to a large family child care home is approved pending the following:

-Management's approval

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy CervantesTELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2