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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406011
Report Date: 05/03/2023
Date Signed: 05/08/2023 09:23:17 AM


Document Has Been Signed on 05/08/2023 09:23 AM - 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:PIRES, MARIAFACILITY NUMBER:
444406011
ADMINISTRATOR:PIRES, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 724-1081
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 1DATE:
05/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:07 AM
MET WITH:Maria PiresTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Licensee, Maria Pires, for an unannounced Required- 1 Year Inspection. LPA was granted access to the home by the Licensee and toured both indoors and outdoors during the inspection. Upon arrival, there was 1 preschool-age child and the Licensee present, which is compliant with the home license capacity and ratio requirements. LPA observed all required postings near the entrance to the home and the hours of operation are Monday – Thursday, 8:45AM-2:45PM.

LPA advised the Licensee that if she is caring for only one child from another family that she is not required to maintain a license. LPA advised if the Licensee decides to close her family child care home to mail a letter indicating her last date of care and a copy of her license to the San Jose Regional Office.

The Licensee states that there are no additional adults over the age of 18 residing in the home.

Licensee 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 reviewed facility roster (LIC9040) and fire/disaster drill log and observed the last drill was conducted on 1/11/2023, which is compliant with the six-month requirement for homes. LPA observed a fully charged 2A10BC fire extinguisher (last serviced: 10/2022), functioning smoke detector and carbon monoxide detector. The Licensee states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. There are no weapons or firearms in the home.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2023
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: PIRES, MARIA
FACILITY NUMBER: 444406011
VISIT DATE: 05/03/2023
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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 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

Indoor areas of the home were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. Off-limits inside the home include: entire second floor, attached garage, family room, kitchen, living room, one bedroom, and one bathroom. There are no open-faced heaters in the home. The bathroom in the home is clean, sanitary, and operable. There is a working telephone. The Licensee states that she provides all food for the children in care and offers breakfast, lunch, and snack.

The backyard area of the home was inspected and observed to be fenced in. LPA observed sufficient play-equipment and supplies for the children that are in good condition and age-appropriate. Off-limit areas outside of home include: both side yards, and areas outside of fenced area for children. No outdoor bodies of water were observed during todays inspection.

One child’s file and the Licensee's file were reviewed during today's inspection and all required documents were present. The Licensee has current CPR/First-Aid that expires 1/15/2024 and Mandated Reporter Training that expires on 5/6/2024. LPA reminded that training must be renewed every 2 years.

Supervision of children was discussed with the Licensee and she understands that she must be home during day care hours and ensure that children are supervised at all times. The Licensee states that she does not transport any day care children.

Exit interview conducted and report was reviewed with the Licensee, Maria Pires.

As a result of todays inspection, no deficiencies were cited.

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: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
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