434409251-2-13-2020-07-CC-JTSE-BLRUUF-20200213145327

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434409251
Report Date: 02/13/2020
Date Signed: 02/13/2020 02:53:36 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:	GARZA, CELIA		FACILITY NUMBER:	434409251
ADMINISTRATOR:	CELIA GARZA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 425-1638
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95148
CAPACITY:	14	CENSUS: 3	DATE:	02/13/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Celia Garza		TIME COMPLETED:	03:00 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	LPA Janet Tse met with licensee Celia Garza for a required-one year inspection. Present were three children with Licensee in the home. Two of the children are Licensee's grandchildren. Adults living in the home are Licensee and her nephew. Days and hours of operation are Monday to Friday, 7:00am to 5:00pm. LPA toured the indoor and outdoor of the home. LPA observed a blocked and covered fireplace. Off limits indoor: living room, family room, kitchen, dining room, master bedroom, master bathroom, two bedrooms, and the garage. LPA observed the garage is converted. There are no bodies of water. Licensee stated there is no firearms/weapons in the home. Sharp objects, medicines, poisons and cleaning supplies were inaccessible to the children. Outdoor area is fenced. Off limits outdoor: both side yards. LPA reminded Licensee that she can only have 14 children according to her license. Fire extinguisher is size 3A40BC and filled. Smoke and carbon monoxide detectors are operable. Home is clean and orderly with heating and ventilation for safety and comfort. LPA observed sufficient materials, toys, and play equipment for the day care children. Telephone is in working order. Children were supervised on the visit and LPA went over substitute options. LPA also discussed if Licensee transports children, they are never to be left in parked vehicles and car seat laws are to be followed. A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 02/12/2020 was reviewed; and it indicates that all Facility staff or other individuals who require caregiver background checks have received criminal clearances and child abuse index clearances or exemptions. LPA observed fire drill log which is to be done every 6 months is current. The last drill practiced was in September 2019. LPA observed the roster of the children is not complete and is not current. LPA Facility Evaluation Report dated 02/13/2020 to be continued on next page: - Page 1 of 2 -

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

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: GARZA, CELIA	FACILITY NUMBER: 434409251
	VISIT DATE: 02/13/2020

NARRATIVE

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Facility Evaluation Report dated 02/13/2020 to be continued from previous page:

observed Licensee has current Pediatric CPR/1^st Aid expiring 07/20/2021.

Licensee was provided the website to download forms, look for resources, and to review regulations: http://www.ccld.ca.gov. Periodic information releases accessible by signing up at: www.myccl.ca.gov.

LPA discussed the immediate civil penalties for Zero Tolerance of $500, and an ongoing $100 per day per violation continues until the violation(s) is corrected. LPA discussed the requirements of AB633 to licensee and provided her the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and licensee understands the requirements. SB792 Immunization Requirements was discussed. LPA observed the required immunization records for Licensee were in file.

Effect of Lead Exposure handout dated 1/20/19 given during today’s inspection. Licensee understands that per Assembly Bill (AB 2370), written information regarding lead exposure needs to be given out to enrolling and re-enrolling parents or guardians. LPA reviewed infants safe sleep policies with Licensee and provided "A Child Care Provider's Guide to Safe Sleep.” More information can be found at https://cdss.ca.gov/inforesources/Child-Care-Licensing. Incidental Medical Services were discussed with the licensee. The licensee is not providing IMS (Incidental Medical Services) at this time. Licensee will submit an updated plan of operation if in the future they provide any IMS services to a child in care.

The Mandated Reporter AB1207 Compliant Child Care Training was also discussed. Website to complete training: https://mandatedreporterca.com. Licensee's primary language is Spanish and is currently exempt from the training.

Deficiency was cited. Notice of site visit was issued and must be posted for 30 days.

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SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: GARZA, CELIA	FACILITY NUMBER: 434409251
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/13/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/28/2020 Section Cited	1 2 3 4 5 6 7	Operation of a Family Child Care Home. Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not met as evidenced by: LPA observed the roster of the children is not complete and is not current.
	8 9 10 11 12 13 14	This poses a potential risk to the Health, Safety, or Personal Right of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Janet Tse	TELEPHONE: (408) 334-8547
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

LIC809 (FAS) - (06/04)

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