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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406186
Report Date: 08/15/2019
Date Signed: 08/15/2019 05:17:41 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:SANTOS, CELESTE & DONALDFACILITY NUMBER:
444406186
ADMINISTRATOR:SANTOS, CELESTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 477-0348
CITY:SOQUELSTATE: CAZIP CODE:
95073
CAPACITY:14CENSUS: 7DATE:
08/15/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Celeste Santos TIME COMPLETED:
05:45 PM
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Licensing Program Analyst (LPA) Zaid Hakim conducted an Unannounced Annual / Random Inspection at the facility today. Upon arrival, LPA observed two (2) infants, five (5) preschool age children, and at least three (3) adults engaging in daily activities and met with Ms. Celeste Santos, Licensee. The Licensee and three other adults the only individuals that reside in the home and all maintain valid background clearance. The days and hours of operation are Monday through Friday 7:00am to 5:30pm. LPA observed required postings; including but not limited to the License to Operate, Emergency Disaster Plan (LIC 610) and Notification of Parents Rights (PUB 393). The facility is licensed for a maximum capacity of 14 children and the Licensee understands capacity options with the combination of age groups. At the time of the inspection LPA observed that the Licensee is in compliance with capacity and ratio requirements and the approved fire clearance.

LPA toured the facility inside and out and observed all indoor and outdoor activity areas. LPA observed door locks, barricade gates, and child proof cabinet locks securing storage areas and off limit areas and which includes the entire second floor which has 1 restroom, 2 bedrooms, a living room, a family room, an office room, and a kitchen. Areas approved for day care use include the entire downstairs which has 3 activity rooms, 1 restroom, and an outdoor play area. The facility is equipped with at least one functioning smoke detector, one carbon monoxide detector, first aid supplies, and at least one 2A10BC fire extinguisher. The last fire safety inspection from the local fire authority was conducted in 05/2019 in which all extinguishers and detectors were serviced. The Licensee understands that fire safety items and fire extinguishers should be maintained at least once every 12 months. Toxic cleaning supplies and other items that pose a danger to children are securely stored in inaccessible locations. The home has sufficient and safe toys, equipment, and supplies. The outdoor play area was observed to be safe and equipped with age appropriate toys and equipment. The Licensee stated that there are no weapons or firearms in the home, no fireplaces in the day care areas of the home, and no bodies of water on the premises. LPA observed the outdoor play area which was equipped with secure perimeter fencing. The Licensee stated that the sand box is covered when not in use and that play equipment is monitored regularly per children's safety.

LPA advised that licensing forms and all other information can be found at: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing

CONTINUATION ON FOLLOWING PAGE (PAGE #2 - REPORT DATED 08/15/2019):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019
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 3
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: SANTOS, CELESTE & DONALD
FACILITY NUMBER: 444406186
VISIT DATE: 08/15/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 08/15/2019):

The Licensee serves snacks and meals to the children and is a participant of a food program. The Licensee stated that she is aware of all food allergies or dietary restrictions of the children and parents are informed of what foods are/may be served at the facility. The Licensee stated that there are no bouncers in the home and understands that bouncers may not be used in family home day cares. The Licensee stated that she understands that children that arrive to the facility in car seats must be removed from car seats upon entry. LPA observed cots, cribs, linens, and blankets for napping. LPA observed all furnishings used by children to be safe and in good condition. LPA and the Licensee discussed safe sleep practices for infants in detail.

The Licensee maintains an accurate roster of enrolled children. The Licensee maintains valid CPR / First Aid training, through an approved vendor, which expires in 04/2021. The Licensee understands that there must be at least one staff on site with Pediatric CPR / First Aid at all times and the primary on site helper maintains CPR / First Aid training with an expiration month of 05/2020 . Emergency disaster drills are done as required, last of which was completed in 05/2019. LPA and the Licensee discussed emergency disaster procedures in the event of a natural or man-made disaster. LPA and the Licensee discussed emergency information regarding the children in care, safety in times of crisis, home surveillance systems in common areas, and emergency supplies maintained in the home, and payment of Licensing fees. The Licensee stated the facility does not take off site field trips and the Licensee does not provide transportation. The Licensee does not assist enrolled children with medications at this time and is aware an Incidental Medical Services (IMS) Plan is required prior to any IMS being provided. LPA confirmed that all staff files reviewed contained completed Mandated Reporter Certificates per AB 1207.

A review of staff records during today's inspection indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also reminded The licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come 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.

CONTINUATION ON FOLLOWING PAGE (PAGE #3 - REPORT DATED 08/15/2019):
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: SANTOS, CELESTE & DONALD
FACILITY NUMBER: 444406186
VISIT DATE: 08/15/2019
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CONTINUATION OF PREVIOUS PAGE (PAGE #2 - REPORT DATED 08/15/2019):

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 (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

LPA reminded the Licensee of the immunization requirement (pertussis, measles, and flu vaccines) for all staff that work directly with the children and the required "Mandated Reporter" training that all staff will be required to complete starting January 1, 2018. LPA and the Licensee discussed recent changes to Mandated Reporter Requirements, Safe Sleep for Infants, Effects of Lead in Drinking Water, Positive Forms of Discipline, and precautions regarding children's outdoor activity time.



A Notice of Site Visit has been issued and must remain posted for 30 consecutive days.

No Deficiencies have been cited as a result of today's inspection.
Exit interview conducted with Ms. Celeste Santos, Licensee
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Zaid HakimTELEPHONE: (408) 497-9236
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3