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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406229
Report Date: 09/26/2019
Date Signed: 09/26/2019 02:15:54 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:ROCHA, LETICIAFACILITY NUMBER:
444406229
ADMINISTRATOR:ROCHA, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 722-4970
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 10DATE:
09/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Leticia RochaTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA), Elizabeth Berumen, conducted an annual random inspection. LPA met with Licensee, Leticia Rocha and explained the nature of today's inspection. Present during the inspection were 10 day care children; 2 infants, 8 preschoolers and her Assistant, Soledad Fernandez.
The day-care is open, Monday - Friday from 6:00 AM to 6:00 PM. Leticia states that herself, and her husband, Rafael Rocha are the only adults living in the home. A review of staff records on 09/25/2019 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 inspected the indoor and outdoor areas of the home. Off limits areas in the home are
Off limit areas in the home are three bedrooms and garage. Off limit areas outside: storage shed and side yards. The home is equipped with a 3A40BC fire extinguisher. The carbon monoxide and smoke detector were tested and proved to be functioning. The home is clean, orderly and safe for children. Backyard is fenced and no bodies of water were observed. LPA observed that cleaning products, sharp objects, medications, and other similar items are stored inaccessible to children. LPA reviewed a facility roster and fire disaster drill log. Last practiced drill fire drill was 09/10/19. Leticia states there are no weapons in the home.
LPA reviewed Leticia and Soledad's file. Leticia has CPR & First Aid certification, expiring on 02/23/2021. Leticia and Soledad both completed the Mandated Reporter Training. Leticia completed her's on March 12, 2018 and Soledad completed hers on March 26, 2019. Maria has immunization against pertussis and measles. Leticia has a signed declaration declining the flu vaccine for personal reasons. Soledad declined the influenza vaccine.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
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 2
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: ROCHA, LETICIA
FACILITY NUMBER: 444406229
VISIT DATE: 09/26/2019
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Supervision of children was discussed with Leticia Rocha and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time, and ratio (age of the children) must be observed with an assistant. Licensee understands that if she transports children via vehicle, children cannot be left in parked vehicles unattended at any time.
LPA discussed Zero Tolerance with $500 immediate civil penalty. LPA discussed the requirements of AB633 with the licensee. Incidental Medical Services were discussed with the licensee. The licensee is not providing Incidental Medical Services (IMS) at this time.

LPA referred the Licensee to the Department website: www.ccld.ca.gov for additional information on the online training. LPA advised licensee of the pending Department regulation update re: Safe sleep for infant children.
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 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 Licensee with, Effects of Lead exposure flyer to handout to parents.

LPA conducted an exit interview with Leticia Rocha in Spanish. No deficiencies were cited.

Notice of site visit was issued and must be posted for 30 days.

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

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
LIC809 (FAS) - (06/04)
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