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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434409899
Report Date: 03/24/2023
Date Signed: 03/24/2023 02:32:56 PM


Document Has Been Signed on 03/24/2023 02:32 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:MARTINEZ, ROSARIOFACILITY NUMBER:
434409899
ADMINISTRATOR:MARTINEZ, ROSARIOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 249-4450
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY:14CENSUS: 5DATE:
03/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Rosario MartinezTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection to the home today. LPA met with Rosario Martinez, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Friday 7:15 AM to 4:30 PM. Licensee stated she and her husband Fernando are the adults that reside in the home. LPA observed there were five children present in the home during the inspection, including one infant and four preschool children. Certification for CPR and First Aid Card for Licensee is current and will expire on 3/28/23.

LPA toured the indoor and outdoor areas of the home during today's inspection. LPA obtained a copy of the children's roster today and it is current. LPA reviewed five children files and observed files are complete. LPA observed that Licensee has conducted a fire drill during the last six months. Last fire drill was documented on 12/14/22.
The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas inside are: Three bedrooms, Living room, dining room, kitchen, two bedrooms, and the attached garage. LPA observed the laundry area is located in the off limits garage. Off limits areas outside: The home is located in a corner and the off limits area is an small back yard. Licensee uses the left side yard as playground for the children in care. LPA observed the back and side yards are fenced,
LPA observed a fully charged 2A10BC fire extinguisher and at least one working smoke detector. LPA observed the home has a carbon monoxide detector. LPA observed there are not stairs in the home. LPA observed the home does not have wall heaters, or bodies of water. LPA observed a barricaded fireplace located in the off limits living room. Licensee stated she does not have any pets. 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.

*******************Report dated 03/24/23 continues in page 2.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2023
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: MARTINEZ, ROSARIO
FACILITY NUMBER: 434409899
VISIT DATE: 03/24/2023
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Report dated 3/24/23 continues from page 1

According with the SB792, Licensee has proof of immunization for herself for pertussis, measles, and influenza.
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 current capacity options and she understands that she cannot have more than 14 children in the home at any time, ratio (age of the children) must be observed, and a helper must be present whenever there are more than 8 children in care. Licensee understands in absence of a helper her license capacity is reduced to 8 only and ratio must be observed. The Licensee states that she does transport children via vehicle and that she understands that children cannot be left in parked vehicles unattended at any time. Licensee uses redirection and communication with children as a form of discipline.

Department website: www.ccld.ca.gov provided to Licensee.
LPA observed licensee has completed the mandated reporter training on 7/28/21, Licensee understands the training is mandatory for all the adults in her home in contact with the children in care and training shall be renewed every two years. LPA provided the training website www.mandatedreporterca.com to the licensee for additional information on the online training.

A review of staff records on 3/20/23 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 Rosario Martinez 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.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

************** Report dated 3/24/23 continues on page 3.

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
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: MARTINEZ, ROSARIO
FACILITY NUMBER: 434409899
VISIT DATE: 03/24/2023
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Report dated 3/24/23 continues from page 2.

LPA also informed licensee 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.

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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Exit interview conducted and report was reviewed with the licensee Rosario Martinez in Spanish.

No deficiencies were cited today.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Fermin Campos-JaramilloTELEPHONE: 408-334-8557
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
LIC809 (FAS) - (06/04)
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