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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406184
Report Date: 11/05/2021
Date Signed: 11/09/2021 01:38:18 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:MORALES, MARIAFACILITY NUMBER:
444406184
ADMINISTRATOR:MORALES, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 763-1056
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 8DATE:
11/05/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Maria MoralesTIME COMPLETED:
02:00 PM
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On 11/05/2021, Licensing Program Analyst (LPA) Elizabeth Berumen met with Licensee, Maria Morales for an annual inspection and explained the reason for the visit to her. Present during today's visit were licensee, her assistant (Tayde Aguirre) and 8 children; 3 of the children are infants; one is under 12 months. Maria states there are two adults living in the home; herself, her husband (Pablo Hernandez-Morales).
Licensee provided LPA with her cell phone 831-840-5546 and email address Elodia.morales.57@yahoo.com.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 11/05/21 was reviewed and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. 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 inspected inside and outside of the home. LPA observed a barricaded fire place in living room. Licensee stated there are no weapons. LPA observed a 3A40BC fire extinguisher in kitchen area and one in the outside activity room. LPA tested the carbon monoxide detector and smoke detectors. Sharp objects, medicines, poisons and cleaning supplies are inaccessible to the children. Backyard is fenced. LPA observed that Maria made alterations to her family child care home, the licensee did not shall notify the Department of the proposed change. Licensee converted bedroom (located across from bathroom) to a dining room area; opened up wall.

The home now has two bedrooms; bedroom to the right of the bathroom is off limits (Licensee's bedroom). Maria is using a detached room for day care activities that is located outside. Licensee states that children nap inside the home and are currently eating outside. LPA will follow up with fire department regarding the back room. The detached room has a fire extinguisher, smoke and carbon monoxide detectors. LPA reminded Licensee that she shall provide the Department with a copy of an inspection report when an inspection is required by the local building department.

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
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 8
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: 11/05/2021
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Children were supervised during the visit and LPA went over substitute options and reminded licensee they could only have 14 children according to their license. Licensee stated she does not transport children, LPA reminded Licensee that children are never to be left in parked vehicles and must use appropriate car seats according to the child's age/weight/size.

LPA reviewed Licensee's and Assistant (Tayde Aguirres') file. Licensee has current CPR and First Aid certifications. Licensee and Assistant completed mandated reporter, AB1207. Licensee understands the course it to be renewed every two years.

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.

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 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 the Licensee at the conclusion of the inspection.

NOTICE OF SITE VISIT WAS ISSUED AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)(3)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects. (3) There shall be no objects hanging above or attached to the side of the crib.

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 a mobil hangin over a crib which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2021
Plan of Correction
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Licensee will send a picture of the crib without the mobil hanging above it.
Type B
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 and record review, the licensee did not comply with the section cited above. Licensee failed to notify the department that she opened up a wall and converted previous bedroom into a dining room area. Licensee is using and off limit bedroom for infant napping area which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2021
Plan of Correction
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Licensee to update the facility sketch, identify each room ie bathroom, kitchen etc. Identify the off limit areas, label doors and windows, identify emergency exits, show room sizes and keep to scale. 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.
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: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:
DATE: 11/05/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2021
LIC809 (FAS) - (06/04)
Page: 6 of 8