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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444407145
Report Date: 03/11/2025
Date Signed: 03/11/2025 11:39:24 AM

Document Has Been Signed on 03/11/2025 11:39 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:AGUIRRE, IRENEFACILITY NUMBER:
444407145
ADMINISTRATOR/
DIRECTOR:		AGUIRRE, IRENEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 421-0321
CITY:SANTA CRUZSTATE: CAZIP CODE:
95062
CAPACITY: 14TOTAL ENROLLED CHILDREN: 30CENSUS: 10DATE:
03/11/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Irene AguirreTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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At 9:00AM, Licensing Program Analyst (LPA) Angela Luz met with Licensee Irene Aguirre to conduct an unannounced annual RANDOM inspection. Present for this inspection was 2 infants, 8 preschool aged children, and 2 fingerprint cleared staff. The home was toured to conduct a Health and Safety Inspection. Days and hours of operation are from Monday-Thursday 8AM - 4:30PM. Spanish is spoken to the children in care.

Facility:
The OFF LIMIT AREAS are the primary bedroom, primary bathroom, and front yard. The ON LIMIT AREA is the backyard that includes an indoor playroom with adjoining bathroom that is separate from the home and the living room, kitchen, 2 bedrooms, and 1 bathroom. Off limit areas are inaccessible by closed and/or locked doors and visual supervision. The indoor playroom is neat and clean with heating and ventilation for safety and comfort. Children in care use the indoor playroom and backyard for the majority of their time at the home. The ISOLATION AREA is the couch by the entrance gate. The outdoor play area is free from defects or dangerous conditions and is fully fenced. There is a sandbox in the play area that gets covered by a tarp every night.

There have been no changes from the areas previously identified as OFF LIMITS or alterations to existing building or grounds. There are no bodies of water. All hazardous materials and toxins are kept out of the reach of children. Licensee states that any poisons are stored in a high cabinet above the laundry area. Licensee states that there are no firearms in the home. The home has a fully charged 3A40BC fire extinguisher that was last serviced on 8/23/2024, working smoke detector, working carbon monoxide detector, and working telephone. LPA reminded that fire extinguishers should be serviced once a year.

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Belinda DevallTELEPHONE: (408) 324-2128
Angela LuzTELEPHONE: (916) 931-9802
DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: AGUIRRE, IRENE
FACILITY NUMBER: 444407145
VISIT DATE: 03/11/2025
NARRATIVE
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Care and Supervision: There are ample age-appropriate toys that appear to be safe and in good condition. Licensee understands Infant Safe Sleep requirements. Licensee uses talking with the child as forms of discipline. Licensee understands that children's personal rights should not be violated, including but not limited to, no corporal punishment, interference with eating, intimidation, or other actions of a punitive nature. Children are treated with dignity, receive safe, healthful, and comfortable accommodations. Licensee understands how to report Unusual Incidents/Injuries.

Records: The Licensee CPR and First Aid certificate is current and expires 8/28/26. Licensee Mandated Reporter Training for Child Care Providers is expired. Licensee was reminded of Mandated Reporter Training (AB1207) and CPR/First aid certifications needs to be renewed every two years. A copy of the licensee’s immunization is on file. The Licensee conducts and documents fire and disaster drills every six months, last drill was on 1/8/25. A current copy of the facility roster was viewed, and a copy was obtained. Licensee does not carry liability insurance for the daycare and issues Affidavit Regarding Liability Insurance (LIC 282) to enrolled families. Entrance checklist for Family Child Care Home was provided and licensee was reminded of documents to be posted in a prominent, publicly accessible area of the facility.

LPA reviewed five (5) children files during today's inspection for the following records: Notification of Parents Rights (LIC995A), Consent for Emergency Medical Treatment (LIC627), Identification and Emergency Information (LIC700), and Immunization records. Documentation of infant sleep checks every 15 minutes that notate any signs of distress are maintained in infant files.

LPA, Luz reviewed three (3) staff (S1-S3) files for the following records: Employee rights (LIC 9052), Statement Acknowledging Requirement to Report Child Abuse (LIC 9108), immunization records, and required training. Staff 1-3 Mandated Reporter training was expired.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.
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SUPERVISOR'S NAME: Belinda DevallTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Angela LuzTELEPHONE: (916) 931-9802
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: AGUIRRE, IRENE
FACILITY NUMBER: 444407145
VISIT DATE: 03/11/2025
NARRATIVE
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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-andresources/safe-sleep as an additional resource. LPA also informed 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE, Irene Aguirre confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Megan's Law was checked on 2/28/25.

During today's inspection, 1 Type B deficiency is issued on attached page 809-D.
  • Expired Mandated Reporter Training for Staff 1-3.
1 advisory notes is issued.
  • Issue LIC 282 to newly enrolled families
Appeal rights were provided. A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Licensee, Irene Aguirre.
SUPERVISOR'S NAME: Belinda DevallTELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Angela LuzTELEPHONE: (916) 931-9802
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/11/2025 11:39 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131


FACILITY NAME: AGUIRRE, IRENE
FACILITY NUMBER: 444407145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA record review of mandated reporter trainings, the licensee did not comply with the section cited above in 3 of 3 staff which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/11/2025
Plan of Correction
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By plan of correction due date of 4/11/25, Licensee will submit proof of completed mandated reporter training for all three staff.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Belinda DevallTELEPHONE: (408) 324-2128
Angela LuzTELEPHONE: (916) 931-9802

DATE: 03/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2025

LIC809 (FAS) - (06/04)
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