434409756-6-6-2019-07-CC-MSMS-BCVSF7-20190606134953

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434409756
Report Date: 06/06/2019
Date Signed: 06/06/2019 01:49:58 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:	GARCIA, ERENDIDA		FACILITY NUMBER:	434409756
ADMINISTRATOR:	GARCIA, ERENDIDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 437-3124
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95131
CAPACITY:	14	CENSUS: 4	DATE:	06/06/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Erendida Garcia		TIME COMPLETED:	02:00 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	Licensing Program Analyst (LPA) Mel Matos met with Erendida Garcia, Licensee, for an unannounced annual/random inspection. LPA notes that the Licensee resides in the Diamante townhouse complex and Licensee's home faces McKay Dr. LPA also observed four napping children (2 infants & 2 preschool) in the home during today's inspection. Days and hours of operation are Monday - Friday from 7:00 AM to 6:00 PM. The adults that reside in the home are: Licensee, Licensee's mother, and Licensee's brother. The Licensee's & Licensee's mother certifications for CPR and First Aid are current and expire on January 14, 2020. 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 April 19, 2019. LPA reviewed four children's files and observed current and updated immunization records and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A) in each file. LPA toured the indoor and outdoor areas of the home during today's inspection. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Licensee has an indoor trampoline in the living room. LPA reminded the Licensee that she must comply with manufacturer instructions for use of the trampoline and that only one child can use the trampoline at a time under adult supervision. The home is clean, orderly, and safe for the day care children. LPA did not observe any wall heaters inside the home. Off limit areas in the home (upstairs): 2 bedrooms and 2 bathrooms. Off limit areas in the home (downstairs): kitchen/dining room area, 1 barricaded fireplace (located in the living room), and attached garage. LPA observed barricaded stairs inside the home. Off limit areas outside the home: left side portion of fenced front yard area. LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detector, and fenced front yard area. The home has no backyard. There is a swimming pool, located at the front of the complex, that is appropriately fenced with a self-latching gate. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. The Licensee states that she does not administer any medications to the day care children. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 06/06/2019):

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019

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: GARCIA, ERENDIDA	FACILITY NUMBER: 434409756
	VISIT DATE: 06/06/2019

NARRATIVE

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CONTINUATION OF PREVIOUS PAGE (PAGE #1: REPORT DATED 06/23/2017):

A review of staff records on May 29, 2019 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.

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 with a qualified assistant present. The Licensee states that she does not transport day care children.

LPA conducted an exit interview with the Licensee and advised her of the pending Department regulation update re: safe sleep for infant children. LPA referred the Licensee to the Department website: www.ccld.ca.gov for additional information.

No deficiencies issued during today's inspection.

LPA conducted an exit interview with the Licensee prior to the conclusion of today's inspection and the Licensee agreed to submit proof of completion of the "mandated reporter" training for child care workers for herself as well as proof of the following immunizations: pertussis (Tdap), measles (Mmr), and flu for herself and her mother.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Melvin S Matos	TELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019

LIC809 (FAS) - (06/04)

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