274416057-4-20-2022-07-CC-SCES-CDNQJG-20220420121242

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274416057
Report Date: 04/20/2022
Date Signed: 04/20/2022 12:12:56 PM

Document Has Been Signed on 04/20/2022 12:12 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:	ROCHA ANAYA, KARINA		FACILITY NUMBER:	274416057
ADMINISTRATOR:	KARINA ROCHA ANAYA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 663-7972
CITY:	SALINAS	STATE: CA	ZIP CODE:	93906
CAPACITY:	14	CENSUS: 0	DATE:	04/20/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Karina Rocha		TIME COMPLETED:	12:25 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	On 04/20/2022 at 10:00 AM, Licensing Program Analyst (LPA) Susy Cervantes met with applicant, Karina Rocha to conduct a pre-licensing visit for location change. Applicant's current license is #274415256 which is located at 246 DOUGLAS AVENUE, SALINAS, CA 93906. Applicant stated her husband and herself are the only adults currently living in this home. Applicant has four children ages 17, 15, 11, and 6. Applicant owns the house. Applicant will be getting liability insurance and she understood that if she decides not to carry liability insurance in the future, she will have parent/authorized representative sign the Affidavit Regarding Liability Insurance for FCCH form (LIC 282). Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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. The entire home was inspected for health and safety hazards. The home had a working smoke detector, a working carbon monoxide detector, a working telephone and a 2A10BC fire extinguisher that was serviced on 04/11/2022. Certifications for CPR and First Aid expire 12/13/23. Preventative Health Practices training was complete on 04/02/2022. Applicant has completed Mandated Reporter training on 04/03/2022. Immunizations for Measles, Pertussis, and influenza are on file for applicant. Continues on report dated 04/20/2022 ______________________________ pg. 1/3

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy Cervantes	TELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

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: ROCHA ANAYA, KARINA	FACILITY NUMBER: 274416057
	VISIT DATE: 04/20/2022

NARRATIVE

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Continuation of report dated 04/20/2022 ______________________________ pg. 2/3

Applicant stated that there were no pets or weapons in the home. LPA observed a covered fireplace, gated stairs and no bodies of water. Backyard is fenced. Off limit areas: second floor that has 4 bedrooms and 2 bathrooms, laundry room, garage, right and left side yards, and an office/gym in the backyard. The days and hours of operation will be Monday through Saturday from 5:00 am to 8:00 pm. There were age appropriate toys in the day care areas. Bathroom was clean.

Cleaning products, hazardous and sharp objects were inaccessible to children and stored in the laundry room and top kitchen cabinet. Discipline policy was discussed with applicant and she understood that the children's personal rights should not be violated and corporal punishment is not allowed. Applicant stated that her discipline method will be redirection and speaking to them. Applicant will not transport children but understood the safety seat belt/car seat requirements.

A Family Child Care Home packet was reviewed with applicant. Department's website: www.ccld.ca.gov to obtain forms and regulations CCR, Title 22 was provided. Applicant was advised on the regulations that smoking, baby walkers, bouncers, excersaucers and other similar items are not allowed. The following was discussed, isolation of sick children; supervision of children; capacity options; requirements for reporting suspected child abuse; unusual incident/injuries; fire drills practiced at least twice a year and documented. LPA also discussed the requirements of AB 633 to applicant and provided applicant the fact sheet and a copy of Acknowledgement of receipt of Licensing Reports (LIC 9224). Zero Tolerance with $500 civil penalty was also explained to applicant. LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

LPA discussed the safe sleep regulations with applicant 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 applicant 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.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy Cervantes	TELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

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: ROCHA ANAYA, KARINA	FACILITY NUMBER: 274416057
	VISIT DATE: 04/20/2022

NARRATIVE

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Continuation of report dated 04/20/2022 ______________________________ pg. 3/3

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the applicant Karina Rocha. A review of staff records during today's visit indicates that all staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Fire clearance was granted on 04/11/2022.

LPA advised applicant that licensure for a large FCCH is approved pending the following:

- Fingerprint transfers
- Management's approval

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Susy Cervantes	TELEPHONE: (408) 598-9403
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

LIC809 (FAS) - (06/04)

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