444407145-2-6-2024-07-CC-JBOT-D27Q7K-20240206105516

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444407145
Report Date: 02/06/2024
Date Signed: 02/06/2024 10:55:27 AM

Document Has Been Signed on 02/06/2024 10:55 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, IRENE		FACILITY NUMBER:	444407145
ADMINISTRATOR:	AGUIRRE, IRENE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 421-0321
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95062
CAPACITY:	14	CENSUS: 10	DATE:	02/06/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Irene Aguirre		TIME COMPLETED:	11:15 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Jessica Bongardt met with Irene Aguirre for an unannounced Required – 3-year annual inspection. LPA was granted access to the home by the Licensee. LPA also observed ten children in the home during today's inspection. Licensee was operating within her capacity and ratio requirements. LPA observed the required postings, including the facility license, near the front entrance to the home. Days and hours of operation are Monday to Thursday 8:00 AM to 4:30PM. There are three other adults residing in the home and the Licensee. All are cleared and have TB tests. LPAs reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on 01/31/2024. Licensees state that she does have liability insurance for the day care. Licensee has current CPR and First Aid certifications (expiration:08/29/2024). Licensee have the required vaccines (MMR, Tdap, & flu opt out) and are current with her Mandated Reporter Training for Child Care Workers (expiration:05/15/2024). LPA reviewed four children's files and the files were complete with the required forms. LPA also reviewed the Licensees file and the two helpers that were present today and they have their required documents. Licensees state that a child will be isolated from the other children in the living room part of the day care if necessary due to illness or communicable disease until a parent/guardian is able to pick them up. LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home (831) 421-0321. 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. LPA did not observe any wall heaters inside the home. LPA observed a fully charged (3A40BC) fire extinguisher, working smoke/carbon monoxide detectors, and fenced backyard. No bodies of water were observed. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510)-566-5850
LICENSING EVALUATOR NAME: Jessica Bongardt	TELEPHONE: 408-834-2558
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

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: 02/06/2024

NARRATIVE

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Licensee states that she does not administer any medications to the day care children. Licensee states that she does provides meals (breakfast, snacks, and lunch) 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 states that nobody smokes, and she understands that smoking is prohibited in the home.

The licensee understands that children's personal rights should not be violated, including no unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threats, mental abuse, or other actions of a punitive nature.

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 her capacity/ratio options and she understands that she cannot have more than 14 children present in the home. 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, 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/$3000.00 per person will be assessed if this regulation is violated.

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/.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510)-566-5850
LICENSING EVALUATOR NAME: Jessica Bongardt	TELEPHONE: 408-834-2558
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

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: 02/06/2024

NARRATIVE

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LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

The 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.

Exit interview conducted and report was reviewed with the Licensee, Irene Aguirre. No deficiencies were issued during today's inspection.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510)-566-5850
LICENSING EVALUATOR NAME: Jessica Bongardt	TELEPHONE: 408-834-2558
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

LIC809 (FAS) - (06/04)

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