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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414303
Report Date: 02/11/2022
Date Signed: 02/11/2022 04:00:59 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:LECHUGA, ESTHERFACILITY NUMBER:
434414303
ADMINISTRATOR:LECHUGA, ESTHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 706-8930
CITY:MORGAN HILLSTATE: CAZIP CODE:
95037
CAPACITY:13CENSUS: 1DATE:
02/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:37 AM
MET WITH:Esther LechugaTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Required- 1 Year inspection and Case Management- Legal/Non-compliance inspection. LPA met with Licensee Esther Lechuga and explained the reason for the inspection. Licensee came into the San Jose Regional Office on 02/10/2020 due to children's file. Present during today's inspection were Licensee, her brother, and one child.

Upon arrival of inspection, LPA observed that Licensee is using the family room/ living room, which is off-limits. LPA discussed with Licensee that she needs to inform Licensing if she wants to make any changes to the off-limit areas. LPA inspected the kitchen and living room. LPA observed that there were tools, which includes a blade that is in the packaging, a bottle of Clorax disinfectant cleaning supplies, and medication. All items were accessible to children. LPA also observed that there were knives in the drawer. Licensee moved the tools, bottle of cleaning, medication, and knives to the backyard, which is off-limits for children. Licensee is remodeling her bathroom due to water damage and currently using her garage as a storage. LPA observed that the shower was gutted, but the toilet and sink is functioning. LPA discussed with Licensee that her license is limited to her garage. LPA stated that an updated fire clearance is needed. The kitchen and living room were observed that it is safe for children. LPA reminded her that any tools, medication, cleaning supplies, and anything that could pose an risk to children needs to be inaccessible to children.


------------------------continues on 809 dated 02/11/2022 page 2---------------------------------
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
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 10
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: LECHUGA, ESTHER
FACILITY NUMBER: 434414303
VISIT DATE: 02/11/2022
NARRATIVE
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--------------------------continuation on 809 dated 02/11/2022 page 1----------------------------

LPA inspected the inside of the home. The off-limit areas of the home are all 3 bedrooms and the backyard. LPA reminded to keep any doors to off-limit areas closed. There is fully charged fire extinguisher and functioning smoke detector. Licensee has a carbon monoxide detector, but she needs to replace the battery. LPA reminded Licensee to check that all carbon monoxide detector and smoke detector are functioning. The last fire/disaster drill was conducted on 02/11/2022. LPA reminded Licensee that fire/disaster drill need to be conducted every six months and documented. Licensee stated that there are no weapons, such as firearms, stored in the home.

LPA discussed the safe sleep regulations with licensee 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 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.

Licensee does not provide Incidental Medical Services (IMS). 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

Licensee does not transport children, but understands that children cannot be left alone and unattended in parked vehicles.

--------------------------continues on 809 dated 02/11/2022 page 3-----------------------------

SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 2 of 10
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: LECHUGA, ESTHER
FACILITY NUMBER: 434414303
VISIT DATE: 02/11/2022
NARRATIVE
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----------------------continuation of 809 dated 02/11/2022 page 2--------------------------------

A copy of the facility roster was obtained. One (1) child's file was reviewed. The records reviewed include, but not limited to Identification and Emergency contact. LPA reminded Licensee to ensure that parents are signing and dating each form.


Licensee's file was reviewed. Licensee's CPR/1st Aid expired on 10/2019. She stated that she will complete the CPR/1st Aid course and send it to Licensing. Licensee is going to register to complete the Mandated Reporter training and send proof to Licensing. Licensee's immunization record for measles is on file. Licensee stated that she will send Licensing her immunization record for pertussis.

The adults over 18 and living in the home are Licensee and her brother. Licensee Esther Lechuga 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.

A updated LIC 279, LIC 9108 for Licensee, and LIC 508 for her brother was obtained during today's inspection.

Licensee stated that she will submit the following:


- LIC 999A
- immunization records for pertussis
- valid CPR/1st Aid card
- Mandated Reporter training certificate

---------------------------continues on 809 dated 02/11/2022 page 4--------------------------------

SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 3 of 10
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: LECHUGA, ESTHER
FACILITY NUMBER: 434414303
VISIT DATE: 02/11/2022
NARRATIVE
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-------------------------continuation of 809 dated 02/11/2022 page 3---------------------------

As a result of this inspection, three Type A, three B citations, one technical violation, and one technical assistant were issued. Exit interview conducted and report was reviewed with the Licensees Esther Lechuga.

LPA Samantha informed Licensee Esther Lechuga that this report dated 02/11/2022 documents two Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Samantha informed the Licensee Esther Lechuga to provide a copy of this licensing report dated 02/11/2022 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 4 of 10
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: LECHUGA, ESTHER
FACILITY NUMBER: 434414303
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. LPA observed that there were medication, knives, tools, and a bottle of Clorax disinfectant that was accessible to children, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2022
Plan of Correction
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Deficiency was corrected during today's inspection. Licensee moved tools, medication, and bottle of Clorax disinfectant to the backyard, which is off-limits to the children, and the knives to the upper cabinet that is inaccessible to children.
Type A
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. Upon arrival, LPA observed that there was a child in the living room/family room, which is off-limits. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2022
Plan of Correction
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LPA inspected the living room, family room, and kitchen during today's inspection. Licensee moved anything that poses an immediate risk to children to an inaccessible area.
An updated fire clearance is needed.
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: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:
DATE: 02/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 5 of 10
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: LECHUGA, ESTHER
FACILITY NUMBER: 434414303
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. Licensee had a carbon monoxide detector, but is not functioning, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/18/2022
Plan of Correction
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Licensee stated that she will purchase a battery for the carbon monoxide detector and send proof to Licensing.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Licensee has not completed the Mandated Reporter training, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/31/2022
Plan of Correction
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Licensee stated that she will complete the Mandated Reporter training and send certificate to Licensing.
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: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:
DATE: 02/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 6 of 10
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: LECHUGA, ESTHER
FACILITY NUMBER: 434414303
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Licensee's CPR/1st Aid card on file expired on 10/2019, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/11/2022
Plan of Correction
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Licensee stated that she will completed the CPR/1st Aid training and send card to Licensing.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:
DATE: 02/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 7 of 10
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: LECHUGA, ESTHER
FACILITY NUMBER: 434414303
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.3(b)
The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. STD 850- Fire clearance granted and license comment states that daycare is limited to converted garage, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2022
Plan of Correction
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Licensee stated that she will submit the updated LIC 999A: facility sketch to Licensing, so STD 850 is updated.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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2
3
4
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: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha YipTELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:
DATE: 02/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/11/2022
LIC809 (FAS) - (06/04)
Page: 10 of 10