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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406252
Report Date: 04/07/2022
Date Signed: 04/07/2022 11:47:49 AM


Document Has Been Signed on 04/07/2022 11:47 AM - 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:RAMIREZ, BENIGNAFACILITY NUMBER:
444406252
ADMINISTRATOR:RAMIREZ, BENIGNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 761-9414
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: DATE:
04/07/2022
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Benigna RamirezTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Elizabeth Berumen met with Licensee, Benigna Ramirez for an announced case management inspection. Licensee's license is currently inactive. Licensee is requesting to be active.

LPA inspected the on limit indoor and outdoor areas of the home. Licensee identified the off limit areas as 4 bedrooms including bathroom in master bedroom, two hall closets and garage. Licensee has fenced backyard. LPA notes that there is a stair case that leads to the backyard. LPA observed that the stairs are gated with a door (both ends). LPA explained to Benigna where children less than five years old are in care, stairs shall remain fenced or barricaded.

Adults that live in the home are Licensee, Licensee's husband (Arturo Ramirez Sr), Licensee's son (Arturo Ramirez Jr) Daughter (Jasmine Ramirez) Daughter in law (Margarita Nunez) and son (Israel Ramirez). Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 observed safe toys, play equipment and materials. LPA observed that the home is free from defects or conditions which might endanger a child. LPA observed that the fire place is barricade. Poisons, detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children are stored where they are inaccessible to children. Licensee stores those items in the garage. Licensee states that there are no firearms/weapons in the home.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:
DATE: 04/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2022
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: RAMIREZ, BENIGNA
FACILITY NUMBER: 444406252
VISIT DATE: 04/07/2022
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LPA Berumen reviewed Licensee's file. CPR & First Aid expires on March 17, 2024. Mandated Reporter training was completed on March 20, 2022.

LPA provided Licensee with the Individual Infant Sleeping Plan (LIC9227) and a facility roster.

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. LPA also informed Licensee representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed with Licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Licensee, Benigna Ramirez. LPA Berumen notes that this report was translated in Spanish.

The home is in compliance and LPA Berumen will mail License to Licensee. License status is Active.

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: 04/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022
LIC809 (FAS) - (06/04)
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