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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444409932
Report Date: 09/25/2019
Date Signed: 09/25/2019 03:40:47 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:BONILLA, IRENEFACILITY NUMBER:
444409932
ADMINISTRATOR:IRENE BONILLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 475-4014
CITY:SANTA CRUZSTATE: CAZIP CODE:
95065
CAPACITY:14CENSUS: 8DATE:
09/25/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Irene BonillaTIME COMPLETED:
03:50 PM
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Analyst Behbood met with Licensee Iren Bonilla. Present also were 8 day care children Including 2 infants and 6 preschoolers, and 2 staff. Living in the facility are licensee, her husband and her 12 year old son. Days and hours of operation are Monday through-Friday, from 8 AM to 5 PM. All adults living in the home/working have criminal record clearance as well as child abuse index.

LPA and licensee toured both inside and outside of the home. There are no bodies of water present. Licensee states that there are no firearms/weapons in the home. Medicines, poisons and cleaning supplies are inaccessible to the children. There is a fully charged fire extinguisher, operational smoke and carbon monoxide detectors. Home appears clean, has proper heating, lighting and ventilation for safety and comfort. LPA observed safe and sufficient toys, play equipment, materials and supplies for the day-care. Telephone is in working order. Licensee understands smoking is prohibited. Licensee identified the following off limit area inside the home: 3 bedrooms. Off limit area outside: Two side yards. The playground is fenced with adequate toys.
Supervision of children was discussed with the licensee and she understands that she must be present in the home 80 percent of the time during day care hours and ensure that the children are supervised at all times.
Licensee and her staff have current CPR and First Aid that expires in 2021. Licensee and staff completed Mandated Child Abuse Reporter Training and have proof of immunization against Measles and Whooping Cough. Children's roster is up to date. The fire drills are documented, last fire drill conducted is 08/15/19. Children were supervised during the visit. Licensee states she
No citation issued during today's visit.
SUPERVISOR'S NAME: Anthony StudebakerTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Mahvash BehboodTELEPHONE: (408) 334-8552
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
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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