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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406269
Report Date: 09/30/2022
Date Signed: 10/04/2022 07:38:06 AM


Document Has Been Signed on 10/04/2022 07:38 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:FERNANDEZ, MARIAFACILITY NUMBER:
444406269
ADMINISTRATOR:FERNANDEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 768-8470
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:14CENSUS: 10DATE:
09/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Maria FernandezTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Elizabeth Berumen met with Licensee, Maria Fernandez for a 1 year required inspection. LPA explained the nature of today’s inspection to Licensee. LPA observed ten day care children (two infants). Days and hours of operation are Monday to Friday, 6:00am to 6:00pm. The adults that reside in the home are Licensee, her husband (Conrado Fernandez), adult son (Angel Fernandez) and adult daughter (Elizabeth Fernandez). Licensee has an 8 year old granddaughter that lives in the home.

LPA reviewed a current Child Care Facility Roster. LPA reviewed the fire/disaster drill log; last practiced drill was 09/06/2022. Licensee states that she has liability insurance for the day care. Licensee has current CPR and First Aid certifications (expiration: 12/05/2022). Licensee has the required vaccines (MMR, Tdap, & flu - opt out) and is current with her Mandated Reporter Training for Child Care Workers. LPA reviewed ten children's files. LPA reviewed two staff file (Licensee and Husand/Assistant Conrado Fernandez) and the file was complete with the required forms, Mandated reporter training and immunization records.

LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home. The home is clean, orderly, (including heating/air conditioning/ventilation), and safe for the day care children. There are safe & age appropriate toys, play equipment, and materials for the children in the home. The off limit areas inside the home are 3 bedrooms and two bathrooms. Licensee uses portion of her backyard (fenced off area for children). Storage shed is off limits. Licensee the bathroom in day care room for children, dining room area and living room.

LPA observed a fully charged fire extinguisher 2A10BC. The smoke and carbon monoxide detectors were tested and proved to functioning. The wall heater in living room area is barricaded. No bodies of water were observed. Licensee states that she does not have any weapons. Licensee has a pet dog that is kept in off limits outside area. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Licensee understands that any poisons are to be locked and inaccessible to the day care children.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth BerumenTELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:
DATE: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/30/2022
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: FERNANDEZ, MARIA
FACILITY NUMBER: 444406269
VISIT DATE: 09/30/2022
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Licensee states that she provides all meals, including breakfast, lunch, and snacks to the day care children. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored. Licensee has a first aid kit in the home which includes a touch less thermometer. Licensee understands that smoking is prohibited in the home.

Licensee states that she does administer any medications to the day care children when needed. 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

Supervision of children was discussed with the Licensee 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 the capacity/ratio options and she understands that she cannot have more than 14 children present in the home without at least two qualified adults present. Licensee states that a child will be isolated in the living room area if necessary due to illness or communicable disease. Licensee states that she does not transport any day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

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 discussed the safe sleep regulations with the 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 the Licensee 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

Exit interview conducted and report was reviewed with the Licensee, Maria Fernandez. No deficiency cited.

A Notice of Site Visit was given 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: 09/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2022
LIC809 (FAS) - (06/04)
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