444408153-6-26-2019-07-CC-EBEN-BDHR6S-20190626124512

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444408153
Report Date: 06/26/2019
Date Signed: 06/26/2019 12:45:18 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:	LOPEZ, MARIA		FACILITY NUMBER:	444408153
ADMINISTRATOR:	MARIA LOPEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 761-2108
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 12	DATE:	06/26/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:11 AM
MET WITH:	Maria Lopez		TIME COMPLETED:	12:45 PM

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) Elizabeth Berumen conducted an unannounced Annual Random inspection to the facility. LPA met with Licensee, Maria Lopez and explained the nature of today's inspection. There were 12 day care children (2 infants and 10 preschoolers) present during today's inspection. Licensee's Assistant, Gisela Garcia was also present. A review of staff records on 06/20/19 indicates that all staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Days and hours of operation are as follow: Monday to Friday 6:00 AM to 6:00 PM. LPA inspected parts of the facility in which family day care services are being provided and areas which children have access. The off limit area inside the home are two bedrooms and garage (converted to a room). The kitchen area is used as a passage way to the play room and to the backyard. The play room, located next to the kitchen and the front family room are the main areas of the day care. The bathroom used for children is clean. Off limit areas outside is the locked storage shed and fenced areas surrounding the day care play area; appears to be used as storage. Those areas are gated to prevent children from accessing the area. LPA observed sufficient materials, toys, and play equipment for the day-care children. The home appears clean and safe for the day-care children. Licensee owns the home. LPA observed a fully charged 3A:40BC fire extinguisher. The carbon monoxide detector and smoke detector were tested and proved to be functioning. Medicines, cleaning products, hazardous and other toxic materials are inaccessible to children. Maria Lopez has locks on her kitchen and bathroom sinks. Licensee stated that there are no weapons in the home. LPA reminded licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. LPA reviewed child care facility roster and obtained a copy. LPA reviewed fire disaster drill log; last practiced fire drill was June 11, 2019 and last practiced earthquake drill was June 18, 2019.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

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: LOPEZ, MARIA	FACILITY NUMBER: 444408153
	VISIT DATE: 06/26/2019

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
26
27
28
29
30
31
32

LPA reviewed Maria Lopez' and Assistant Gisela Garcia file. Gisela has TB test, fingerprint clearances. Maria states she mailed immunization of pertussis, measles, influenza for Gisela Garcia to CCL. Maria Lopez has immunization against pertussis, measles and influenza. Maria Lopez' has CPR & First Aid certifications, expiring on 01/30/21. Licensee submitted Tb test, LIC 508 and criminal record clearances for her son (Sebastian Lopez Garcia) who turned 18 on April 19, 2018. LPA requested an updated Application for Family Child Care home (LIC 279) to be mailed to LPA.

Incidental Medical Services were discussed with the licensee. This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication was done today. No child currently enrolled is being provided IMS.

Licensee states that she talks to children and redirects them as form of discipline. Licensee understands that children's personal rights should not be violated, corporal punishment is not to be used. Licensee understands her capacity options and she understands that she cannot have more than fourteen children in the home at any time. Licensee does not transport the children.

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.

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 Senate Bill 792, Assembly Bill (AB) 1207 (Mandated Child Abuse Reporter Training) which is required training that began on January 1, 2018 and requires renewal every two years.

AB 633 was discussed with licensee. Licensing forms, Title 22 regulations, can be obtained through the internet at www.ccld.ca.gov. Mandated Reporter Training can be accessed at www.mandatedreporterca.com.

No deficiency was observed during today's inspection.
A Notice of Site visit was posted at time of inspection and must remain posted for 30 days. Exit interview conducted with Maria Lopez. Copy of report and appeal rights were provided.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2