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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274416288
Report Date: 11/17/2021
Date Signed: 11/17/2021 01:28:21 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:VALENCIA, SUSANAFACILITY NUMBER:
274416288
ADMINISTRATOR:VALENCIA, SUSANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 789-5696
CITY:SALINASSTATE: CAZIP CODE:
93901
CAPACITY:14CENSUS: 2DATE:
11/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:56 AM
MET WITH:Susana ValenciaTIME COMPLETED:
01:35 PM
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Licensing Program Analyst (LPA) Joe Macias conducted an unannounced Required - 1 Year Inspection (care tool). LPA was greeted and granted entrance by the Licensee Susana Valencia. The purpose of today’s inspection is to ensure the home is in compliance with Title 22 California Code of Regulations. Todays census is 2 (1 infants, 1 preschool age). The Licensee and her adult sons Rafael Tapia, and Francisco Tapia are the only adults who reside in the home. The day care hours of operation are Monday - Friday, 5am - 6pm. The Licensee's CPR and First Aid are current, and expire September 2022. The Licensee's fees are current.

LPA toured the indoor and outdoor areas of the home during today's visit. LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's visit. The last fire disaster drill was conducted on June 4, 2021. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the children in care. The home is orderly, and safe for the day care children. LPA observed a barricaded fireplace in the home. Off limit areas of the home: all bedrooms, bathroom #1, and detached garage.

LPA observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, and no bodies of water. The Licensee states that she does have weapons in the home. The Licensee's son Officer Francisco Tapia stores a gun safe in the detached garage which is off limits. The firearms and ammunition are stored separately. All detergents, cleaning compounds, poisons, medications, and other similar items are out of reach and inaccessible to children. Licensee states that she does not administer medications at this time. LPA reviewed the RAST procedure with the Licensee.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours to ensure that the children are safe and supervised at all times. The Licensee understands the current capacity options and she understands that he cannot have more than 14 children in the home at any time with a qualified assistant present. LPA provided the Licensee with the ratio/capacity chart for his reference. The Licensee states that she does transport children; and understands that children cannot be left in parked vehicles unattended any time.

LPA observed staff immunization records on file.

SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
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: VALENCIA, SUSANA
FACILITY NUMBER: 274416288
VISIT DATE: 11/17/2021
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LPA discussed the safe sleep regulations with the License 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 licensee [facility representative] 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.

A review of staff records on November 17, 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. Licensee Susana Valencia 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

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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



The Licensee has completed the Mandated Reporter Training.

No deficiencies cited. Exit interview conducted and report was reviewed with the Licensee Susana Valencia.



A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2