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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274450279
Report Date: 01/17/2024
Date Signed: 01/17/2024 01:59:41 PM

Document Has Been Signed on 01/17/2024 01:59 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:CAMARENA, CELSAFACILITY NUMBER:
274450279
ADMINISTRATOR:CAMARENA, CELSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 758-9534
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 1DATE:
01/17/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Celsa CamarenaTIME COMPLETED:
02:10 PM
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Licensing Program Analysts (LPAs) Fermin Campos-Jaramillo and Martha Jimenez-Villanueva conducted a case management inspection to the home today, LPAs met the licensee Celsa Camarena, The Licensee Camarena has submitted an application for reduction of capacity on her Family Child Care Home (FCCH) license. LPAs observed there was a preschool age child in care today. Days and hours of operation are Monday to Friday from 5:30 AM to 5:30 PM. The adults that reside in the home are the Licensee, her husband Fernando, her daughter Elizabeth, her grandson Ivan, and her son in law Anselmo. Licensee stated that also in the home resides licensee's 3 years old grandchild. Licensee's certifications for CPR and First Aid are current and will expire on 1/08/25 for both licensee and her husband.

LPA toured the indoor and outdoor areas of the home during today's visit. LPA obtained a copy of the children's roster and it is current. LPA reviewed the Fire/Disaster drill log during today's visit. The last fire drill was documented on 1/5/24. Licensee has a working telephone in the home. LPA did not observe any wall heaters inside the home. Off limit areas in the home: 4 bedrooms and one bathroom, and the attached garage. The home has a barricaded fireplace located in the on limits area. There are not stairs in the home. Off limit areas outside the home: 2 small sheds in the back yard and the right and left side yards. Licensee keeps an small dog in the right side yard and stated the dog has been vaccinated.
LPA observed a fully charged 3A40BC fire extinguisher, working smoke and carbon monoxide detectors. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. Licensee and her helpers have proof of the immunization for measles, pertussis and influenza according with the SB792.
Supervision of children was discussed with the licensee. Graphic material showing the ratio combinations for an small license was provided to licensee. The Licensee understands her capacity options and she understands that she cannot have more than 8 children in the home at any time and ratio (age of the children) must be observed.
Department website: www.ccld.ca.gov provided to Licensees.

Report dated 1/17/24 continues on page 2.
Susy Cervantes
Fermin Campos-Jaramillo
DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: CAMARENA, CELSA
FACILITY NUMBER: 274450279
VISIT DATE: 01/17/2024
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Report dated 1/17/24 continues from page 1.

LPA observed that licensee and her husband have completed the Mandated Reporter training on 2/7/22 and 3/15/22 respectively. LPA informed licensee that all the adults in contact with children in her home are required to complete the training. LPA referred the Licensee to the training website: www.mandatedreporterca.com for additional information on the online training.

A review of staff records on 1/16/24 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 was reminded that all the adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

There are no deficiencies cited today.

A notice of site visit was handed to licensee and must remain posted for 30 days.

Licensee was informed that a small FCCH license with capacity 8 will be approved pending on management approval

SUPERVISOR'S NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
LIC809 (FAS) - (06/04)
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