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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274416180
Report Date: 06/18/2021
Date Signed: 06/30/2021 03:34:58 PM

Document Has Been Signed on 06/30/2021 03:34 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:DUFF, ALMAFACILITY NUMBER:
274416180
ADMINISTRATOR:ALMA DUFFFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 585-0881
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
06/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Alma Duff TIME COMPLETED:
03:10 PM
NARRATIVE
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Licensing Program Analyst (LPA) Elizabeth Larios met with Alma Duff, Licensee, for an unannounced Required – 1 year annual inspection. LPA were granted access to the home by the Licensee. LPA also observed 5 children (1 infant, 1 toddler, and 3 preschool). The Licensee was operating within her capacity and ratio requirements during today's inspection. LPA observed the required postings, including the facility license, near the front entrance to the home. The home has a working telephone (831) 585-0881. Days and hours of operation are Monday - Friday from 6:00AM to 5:30PM. The Licensee is the only adult residing in the home. The Licensee's and her assistant CPR and First Aid are current and expire in 11/2021.

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on 5/24/2021. The Licensee, Licensee's assistant, have the required vaccinations (MMR, Tdap, & flu). The Licensee has current Mandated Reporter Training for Child Care Workers on file (exp: 07/19/21) but not staff. LPA reviewed five children's files and observed current and updated Identification and Emergency Information (LIC 700) and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A) in each file. The Licensee states that a child will be isolated in the front entry way of the day care room if needed to because of illness or communicable disease.

Safe sleep updated: LPA discussed the new “Safe Sleep” regulations with the Licensee and provided a copy of the regulations, including the Individual Infant Sleeping Plan (LIC 9227) form to the Licensee.

REPORT CONTINUED ON FOLLOWING PAGE #2 - REPORT DATED 06/18/2021
SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2021
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: DUFF, ALMA
FACILITY NUMBER: 274416180
VISIT DATE: 06/18/2021
NARRATIVE
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 06/18/2021)
LPA reminded the Licensee that infants up to 12 months of age must sleep on their backs, shall be supervised while they are sleeping, and documentation of sleep checks must be kept in each infant’s file. Infants shall not be swaddled. There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards shall be free of loose articles and objects.

LPA toured the indoor and outdoor areas of the home during today's inspection. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is clean, orderly for the day care children. LPA observed in the backyard where child play a shovel, hedge shear, hoe, lawn mover, grass cutter, and pressure cleaner accessible to children. There are stairs inside the home. LPA observed a secure installed gate at the bottom of the staircase. There is a fireplace inside the home that is screened. Off limit areas the second floor, garage, living room, and kitchen.

LPA observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, poisons, medications, and other similar items are out of reach and inaccessible to children.

A review of staff records on June 18, 2021 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also reminded the Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

REPORT CONTINUED ON FOLLOWING PAGE #3 - REPORT DATED 06/18/2021
SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
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: DUFF, ALMA
FACILITY NUMBER: 274416180
VISIT DATE: 06/18/2021
NARRATIVE
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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 06/18/2021)
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 without a fully qualified adult present. The Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

LPA discussed the requirements of AB 633 with the Licensee and provided her the AB 633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and the Licensee understands the requirements. LPA also discussed "zero tolerance" related regulations with the Licensee and advised her of the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.

Website for provider resources:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

LPA conducted an exit interview with the Licensee and deficiencies were issued during today's inspection.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Anthony Studebaker
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 06/30/2021 03:34 PM - It Cannot Be Edited


Created By: Elizabeth Larios On 06/18/2021 at 01:02 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: DUFF, ALMA
FACILITY NUMBER: 274416180

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/18/2021
Section Cited
CCR
102417(g)(4)

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Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement was not met as evidenced by: LPA observed in the
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Licensee removed the items that pose a risk to the health and safety to children in care and stored them inaccessible to the children during the inspection. Deficiency is cleared during today's inspection.
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backyard where child play a shovel, hedge shear, hoe, lawn mover, grass cutter, and pressure cleaner accessible to children.This poses a potential risk to the health and safety to the children in care.
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Type B
06/18/2021
Section Cited
HSC1596.8662(4)(b)(1)

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AB 1207 Mandated Child Abuse Reporting Training. On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider.shall complete renewal mandated reporter training every two yearsfollowing the date on which he or she completed the initial mandated reporter
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Staff shall complete the Mandated Reporter AB1207 Compliant Child
Care Training and forward a copy of the certification to LPA by 07/2/2021 due date.
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training. This requirement was not met as evident by: LPA observed employee did not complete the training and does not have a certification in file.This poses a potential risk to the Health, Safety or Personal Rights to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Anthony Studebaker
LICENSING EVALUATOR NAME:Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:
DATE: 06/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/18/2021


LIC809 (FAS) - (06/04)
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