444406124-6-30-2022-07-CC-CNEN-CFVUF5-20220630153211

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444406124
Report Date: 06/30/2022
Date Signed: 06/30/2022 03:32:23 PM

Document Has Been Signed on 06/30/2022 03:32 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:	NOVELO, BEATRICE		FACILITY NUMBER:	444406124
ADMINISTRATOR:	NOVELO, BEATRICE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 722-6566
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 8	DATE:	06/30/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:46 PM
MET WITH:	Beatrice Novelo		TIME COMPLETED:	03:42 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), Cortney Nelson, met with Licensee, Beatrice Novelo, 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 were 8 children (5 preschool-age/ 3 school-age), Assistant, Aurora Rocha, and Licensee present, which is compliant with the home license capacity and ratio requirements. LPA observed all required postings near the entrance to the home. Hours of operation for the facility are Monday – Friday, 7:30AM-3:30PM. Licensee states that adults, over the age of 18, residing in the home are: herself and her sons (Giovanni & Brandonn). All adults residing in the home have Criminal Background Check Clearance and signed Criminal Record Statements (LIC508). 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 during todays inspection. The last fire/disaster drill was conducted in 4/2021, which is not compliant with the six-month requirement for homes. LPA observed a fully charged 3A40BC fire extinguisher (last serviced: 2/2022), functioning smoke detector and carbon monoxide detector. 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. The Licensee states that there are no weapons or firearms in the home.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

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: NOVELO, BEATRICE	FACILITY NUMBER: 444406124
	VISIT DATE: 06/30/2022

NARRATIVE

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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 areas inside the home: 3 bedrooms, 1 bathroom, washroom, and attached garage. There are no open-faced heaters in the home. Licensee has a fireplace in the home that is barricaded and safe for the children. Licensee understands that she cannot use the fireplace units during day care hours. LPA observed sufficient age-appropriate materials, toys, and play equipment in the home. Drinking water is readily available for children in the facility via water dispensers and cups labeled with the children’s names. All food is prepared and provided by the facility through the Community Bridges Food Program. The bathroom in the home is clean, sanitary, and operable. The Licensee has a working telephone in the facility.

The backyard area of the home was inspected and 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: right side yard where Licensee's pet dogs are held during day care hours. LPA observed plastic structure outside that is cracking and should be removed from day care children use. Wooden play structure outside has some visible damage from the dogs and termites. Playground is currently stable and safe for use, however LPA advised Licensee to monitor the areas of the structure that are impacted. Sandbox under the playground structure is raked daily and checked before children arrive for care. No outdoor bodies of water were observed during todays inspection. Licensee states that she purchased a hot tub and has a proper cover with locks, however it has not been delivered yet. LPA advised Licensee on requirements for hot tub safety.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

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: NOVELO, BEATRICE	FACILITY NUMBER: 444406124
	VISIT DATE: 06/30/2022

NARRATIVE

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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.

8 children’s files were reviewed during todays inspection and all required documents were present, including Notification of Additional Children in Care (LIC9150).

Licensee, Assistant, and Home Resident files were reviewed and most required documents were present. The Licensee has current CPR/First-Aid that expires 2/20/2023 and Mandated Reporter Training that expired on 3/9/2022. LPA reminded Licensee that both trainings 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. LPA reminded Licensee that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Exit interview conducted and report was reviewed with the Licensee, Beatrice Novelo.

As a result of todays inspection, deficiencies were cited, see 809-D.

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.

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.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/30/2022 03:32 PM - It Cannot Be Edited

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: NOVELO, BEATRICE	FACILITY NUMBER: 444406124
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/30/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(d)

Operation of A Family Child Care Home

(d) The home shall provide safe toys, play equipment and materials. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above for outside play equipment for children, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/11/2022
	Plan of Correction
1 2 3 4	Licensee will remove broken/cracked plastic play equipment and ripped hanging swing from the outside play area. Swing was removed during inspection. LPA additionally advised Licensee to monitor termite/dog damage to wooden playground for safety. Playground is currently stable and appears safe for day care children.

Type B

Section Cited

CCR

102417(g)(9)(A)

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: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above as last fire/disaster drill was conducted over six months ago (4/2021), which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/08/2022
	Plan of Correction
1 2 3 4	Licensee will conduct disaster/fire drill and record on log by 7/8/2022 and submit copy 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 Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 06/30/2022 03:32 PM - It Cannot Be Edited

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: NOVELO, BEATRICE	FACILITY NUMBER: 444406124
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/30/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above for herself and her assistant, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/22/2022
	Plan of Correction
1 2 3 4	Licensee will submit completed Mandated Reporter training certificate for herself and her assistant (Aurora Rocha) by 7/22/2022. (www.mandatedreporterca.com Child Care Providers- AB1207)

Type B

Section Cited

CCR

102369(b)(9)

102369 Application for Initial License (b) The applicant shall provide all of the following information.. (9) Evidence of a current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home, for any adult home during the time that children are under care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above for her two adult sons who live in the home, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/22/2022
	Plan of Correction
1 2 3 4	Licensee will submit proof of current tuberculosis clearance for her sons (Giovanni & Brandon) by 7/22/2022.

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 Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

LIC809 (FAS) - (06/04)

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