444406184-6-10-2019-07-CC-EBEN-BCZMRJ-20190610095021

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444406184
Report Date: 05/30/2019
Date Signed: 06/10/2019 09:50:25 AM

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:	MORALES, MARIA		FACILITY NUMBER:	444406184
ADMINISTRATOR:	MORALES, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 763-1056
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 5	DATE:	05/30/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Maria Morales		TIME COMPLETED:	01:00 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) Elizabeth Berumen conducted an annual random inspection. Present during the visit were 5 day care children, all are pre-schoolers, and helper (Tayde Aguirre). Licensee's CPR and First Aid is current and expire on 02/28/21. Days and hours of operation are Monday - Friday from 6:00 AM to 6:00 PM. Maria states there are three adults living in the home; herself, her husband (Pablo Hernandez-Morales) and daughter (Edith Morales). LPA inspected the indoor and outdoor areas of the home. LPA observed a fully charged 3A40BC fire extinguisher, working smoke detector, functioning carbon monoxide detector, fenced backyard, and no bodies of water. Off limit areas in the home are 2 bedrooms and garage. Maria is using a detached room for day care activities; today LPA observed that children ate lunch in the detached room. Maria Morales states that the children nap inside the home. The detached room has a fire extinguisher, smoke and carbon monoxide detectors. An updated fire clearance is required for Licensee to use the detached room for day care. Licensee changed a room from being off limits to on limits without notifying the department. Licensee stated that there are no weapons in the home. Cleaning products, medications, sharp objects and other similar items are stored inaccessible to children. LPA reviewed current roster. Last practiced fire disaster drill was 05/16/19 and last earthquake drill was 05/22/19. The backyard is fenced. The fire place in the living room is barricaded. The is a fountain in the backyard that is used as a planter; today it is filled with dirt and plants. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 05/30/19.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019

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: MORALES, MARIA	FACILITY NUMBER: 444406184
	VISIT DATE: 05/30/2019

NARRATIVE

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LPA reviewed Licensee and assistant file; both have immunization against pertussis and measles and a signed declaration declining the influenza vaccine. Tayde Aguirre has TB test, Criminal Record Statement (lic508), statement stating she will report suspected child abuse (lic9108).

Licensee, Maria Morales completed the Mandated Reporter Training on 10/29/17 and understands she is to renew the training every two years. Supervision of children was discussed with Maria Morales. Maria Morales states she does provide transportation services to children and she understands that children cannot be left in parked vehicles unattended at any time.
This facility provides Incidental Medical Services – IMS. LPA did not reviewed storage of medication and equipment/supplies, during today's inspection because no child enrolled is being provided incidental medical services.

LPA discussed Lead Safety Information (AB 2370). Chapter 676, statues of 2018, requires all child care providers, upon enrolling or re-enrolling any child, to provide the parent or guardian with written information. LPA provided Maria Morales with website www.ccld.ca.gov so she can access and print out the Effects of Lead exposure flyer to handout to parents. Safe Sleep was discussed: place infants on their backs when sleeping, use a firm sleep surface such as a mattress in a safety approved crib, keep soft bedding such as blankets, pillows, toys out baby's sleep area and ensure that pacifiers have nothing attached to them. LPA provided a flyer to Maria Morales during today's inspection.

LPA discussed with Licensee the violations that would result in an immediate assessment of civil penalty in the amount of $500. Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, etc.

Exit Interview was conducted. A copy of this report was provided to Licensee, Maria Morales at the conclusion of the inspection.
No Deficiency cited.
NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019

LIC809 (FAS) - (06/04)

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