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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414488
Report Date: 10/09/2019
Date Signed: 10/10/2019 03:57:15 PM

COMPREHENSIVE INSPECTION
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:CARDENAS, MINERVA & ESPINOZA, CHRISTINAFACILITY NUMBER:
434414488
ADMINISTRATOR:CARDENAS, MINERVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 606-0245
CITY:SAN JOSESTATE: CAZIP CODE:
95116
CAPACITY:14CENSUS: 10DATE:
10/09/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:47 PM
MET WITH: Carenas C. Meinerva TIME COMPLETED:
05:30 PM
NARRATIVE
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On October 9, 2019 Licensing Program Analyst (LPA) Stephanie Collins conducted an annual inspection of the family day care home. LPA met with Licensee, Minerva,Cardena, and explained the purpose of today's inspection.

There are 4 adults residing in the home;The Licensee, her Husband (Jesus Cardena) their two children her niece Christina Espinoza and Teresa Ibarra. Present during the inspection today was Licensee and her Assistant Teresa Ibarra caring for 1 infant and 9 preschoolers.

A review of staff records on 10/7/2019 show that Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who comes 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.

Assistant's First Aid and Pediatric CPR expires on 05/04/2021. Licensee has records showing proof of immunity against Measles and Pertussis.

LPA reviewed a random sample of 4 children's files. Records reviewed include Parents' Rights, immunization, Emergency Contact Information, and Consent for Emergency Medical Treatment form.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
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 5
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: CARDENAS, MINERVA & ESPINOZA, CHRISTINA
FACILITY NUMBER: 434414488
VISIT DATE: 10/09/2019
NARRATIVE
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LPA inspected the indoor and outdoor areas of the home. Smoke and Carbon monoxide detectors were tested and proved to be functioning. Fire and disaster drills were last conducted and recorded on 5/14/2019. Licensee’s home has industrial /commercial fire sprinklers.

Medication, cleaning products and similar items that can pose a danger to children if readily accessible are stored inaccessible to children. Licensee states that there are no weapons in the home. Licensee has one pet dog that is not accessible to the day care children. Per Licensee, the dog is current with vaccination. The backyard is fenced, playground equipment is in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Areas around the climbing equipment, swings and slides have cushioning material to absorb falls. There were no bodies of water observed.

Licensee stated she does not transport children. Licensee has a current and valid Driver License. Licensee understands that children cannot be left in parked vehicles unattended at any time, the motor vehicles used to transport children in care shall be maintained in safe operating conditions, and all vehicle occupants must be secured in an appropriate restraint system.

LPA reviewed with Licensee the maximum capacity for a Large Family Child Care Home License. The maximum number of children for whom care may be provided at any one time when there is an Assistant Provider in the home, including children under age 10 who reside at the licensee's home shall be either: (1) 12 children, no more than four of whom may be infants; or (2) more than 12 and up to 14 children if at least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age and there are no more than three infants being cared for during any time when more than 12 children are being cared for.


Licensee states that currently she is not providing Incidental Medical Services... When any IMS is provided, a Plan of operation, 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.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: CARDENAS, MINERVA & ESPINOZA, CHRISTINA
FACILITY NUMBER: 434414488
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/09/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/31/2019
Section Cited

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HEALTH & SAFETY CODE. Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against [...], pertussis, and measles. [...] The family day care home shall maintain documentation of the required immunizations.
This requirement is not met as evidenced by:
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Per LPA's review of files, Licensee failed to maintain documented proof of Assistant Tersa Ibarra immunization against Measles and Pertussis and (TB) Tuberculosis .

This poses a potential risk to the health and safety of children in care.
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Type B
10/31/2019
Section Cited

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PERSONNEL REQUIREMENTS. 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
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Per LPA's review of Certifications, Licensee Minerva C. Cardena failed to show proof of a current CPR First Aid Card. This poses a potential risk to the health and safety of children in care.
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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: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: CARDENAS, MINERVA & ESPINOZA, CHRISTINA
FACILITY NUMBER: 434414488
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/09/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/31/2019
Section Cited

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MANDATED REPORTER TRAINING. [...] a person who, on January 1, 2018, is a licensed child care provider [...] shall complete the mandated reporter training provided [...] and shall complete renewal mandated reporter training every two years [...].
This requirement is not met as evidenced by:
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Per LPAs' review of files during the inspection, facility assistant Teresa Ibarra and Licensee Minerva C. Cardena failed to show proof of Certification of Completion for the Child Care Mandated Reporter Training. This poses a potential risk to children's health and safety of children in care.
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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: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5
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: CARDENAS, MINERVA & ESPINOZA, CHRISTINA
FACILITY NUMBER: 434414488
VISIT DATE: 10/09/2019
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Beginning January 1, 2019 AB2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” to the facility.

Safe sleep information was reviewed with Licensee.

LPA referred the Licensee to the Department website: www.ccld.ca.gov for additional information.

Regulatory violations were observed during the inspection visit. Therefore, citations were issued. Exit Interview was conducted, where this report, the citations, plan of corrections, and appeal rights were discussed and reviewed with Licensee. A copy of this report was given to Licensee.




A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Stephanie CollinsTELEPHONE: (408) 334-8555
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5