274416209-11-18-2019-07-CC-TDON-BJ2R4J-20191118114138

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274416209
Report Date: 11/18/2019
Date Signed: 11/18/2019 11:41:47 AM

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:	MARTIN, SOCORRO		FACILITY NUMBER:	274416209
ADMINISTRATOR:	SOCORRO MARTIN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 682-8122
CITY:	SALINAS	STATE: CA	ZIP CODE:	93906
CAPACITY:	14	CENSUS: 0	DATE:	11/18/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Socorro Martin		TIME COMPLETED:	11:50 AM

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) Tuoc Doan conducted an announced, scheduled Pre-Licensing inspection of the home. LPA met with Applicant Socorro Martin. Applicant is applying for a license to operate a Large Family Child Care Home (FCCH) with a maximum capacity of 14 at the address listed above. Days and hours of operation will be Monday through Saturday 7:00 AM to 6:00 PM. The Applicant has provided proof of over one years of experience that is required to apply for Large FCCH. The home has been granted a Fire Clearance on 10/29/2019. A copy of the control of property is on file. LPA informed Applicant that if she decides to not carry liability insurance for the Family Day Care Home, she will have to maintain file of affidavits regarding liability insurance signed by each parent of the children that will be enrolled. Applicant has completed 16 hours of training on preventive health practices, which included pediatric cardiopulmonary resuscitation and pediatric first aid, and one hour on Child Care Nutrition. Applicant's Pediatric CPR and First Aid certification expires 08/24/2020. Applicant has documented proof of immunity against Measles and Pertussis. Applicant's Mandated Reporter Training Certificate expires 10/04/2020. Applicant stated that she, her spouse, her son, and her brother are the only adults residing in the home. They have obtained Clearances for Criminal Record and Child Abuse Index Background Check, and Tuberculosis. LPA reminded Applicant about the applicable civil penalties for those adults who have not received fingerprint clearances, who are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day up to $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day up to $3000.00 per person.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019

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: MARTIN, SOCORRO	FACILITY NUMBER: 274416209
	VISIT DATE: 11/18/2019

NARRATIVE

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LPA went over the records that need to be maintained at the home with Applicant. A Family Child Care Home packet with updated Licensing forms was provided to and reviewed with the Applicant. This packet contains information on documents to be made accessible to the Public and documents to be provided to Parents/Legal Guardians. Applicant is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of Laws, etc.

LPA reviewed with Applicant the violations that would result in an immediate assessment of civil penalty in the amount of $500.

LPA also discussed and provided Applicant information regarding continuing requirements, which include but are not limited to the following topics: (1) Separating sick children when they show signs of illness; (2) Supervision of Children; (3) Capacity Options; (4) transportation of children; (5) Procedures for Reporting Suspected Child Abuse and Unusual Incidents/Injuries; (6) Safe Sleep; (7) Healthy Beverages in Child Care; (8) Effects of Lead Exposure flyer; and (9) Posting requirements.

Incidental Medical Services (IMS) policy was discussed. 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.

Exit interview was conducted, where this report was reviewed with Applicant Socorro Martin.

Applicant was informed that a License to operate a Large Family Child Care Home at this address
will not be approved until the following items are submitted to Licensing Office by 12/02/19:

1) During the inspection Applicant informed LPA that she plans to add a fence to keep the side of the backyard where the dog run is part of "Off Limits." Applicant will submit photos of the fence and an updated facility Sketch for the backyard that depicts a current and accurate representation of the layout and use of the backyard.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019

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: MARTIN, SOCORRO	FACILITY NUMBER: 274416209
	VISIT DATE: 11/18/2019

NARRATIVE

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LPA inspected the indoor and outdoor areas of the home. Off Limit Areas inside the home are:
the whole second floor, and the garage and laundry room on the first floor. LPA observed that there was a child safety gate installed at the base of the staircase to prevent day care children from accessing the stairs to the second floor. Backyard is fenced and will be used for outdoor activity. LPA informed Applicant that should she decides to take the children to outdoor areas that are not enclosed with fencing, Applicant must provide on-site supervision at all times.

LPA observed that the home has a fully charged fire extinguisher. Smoke and Carbon Monoxide Detectors were tested and proved to be functioning. The home’s disaster plan of action was discussed along with the requirement for the home to conduct and document fire and disaster drills at least once every six months. LPA reminded Applicant that smoking is not allowed in Family Child Care Homes and baby walkers cannot be used for child in care and needs to be kept inaccessible.

LPA observed toys, equipment, and materials available for day care children to use. The home was clean and orderly, with heating and ventilation for safety and comfort of children in care. Fireplace in the Family Room was screened. Detergents, cleaning compounds, sharps, medicines, and other items which could pose a danger if readily available to children were stored where they are inaccessible, out of reach of children. LPA reminded Applicant that poisons need to be locked.

Applicant stated that there are firearms stored on the premises. LPA inspected the locked storage area for the firearm and confirmed that ammunition were stored and locked separately from firearms. The home has two small sized pet dogs and one medium sized pet dog. The dogs are kept at a designated area in the backyard that was fenced off. Applicant stated that the dogs are vaccinated and will be kept inaccessible to day care children.

Applicant stated that the form of discipline to be used are talking and redirecting the children. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Applicants stated that she understands that the children have personal rights that cannot be waived or abridged regardless of consent or authorization from the child’s authorized representative.

SUPERVISOR'S NAME: Sandy Knight	TELEPHONE: (408)324-2151
LICENSING EVALUATOR NAME: Tuoc Doan	TELEPHONE: (408) 497-7322
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019

LIC809 (FAS) - (06/04)

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