444410310-3-8-2023-07-CC-CNEN-CPQQYC-20230308113455

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444410310
Report Date: 03/08/2023
Date Signed: 03/08/2023 11:35:05 AM

Document Has Been Signed on 03/08/2023 11:35 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, MARIA		FACILITY NUMBER:	444410310
ADMINISTRATOR:	MARIA FERNANDEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 761-3723
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 6	DATE:	03/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:51 AM
MET WITH:	Maria Fernandez		TIME COMPLETED:	11:40 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 Analysts (LPAs), Cortney Nelson and Ashley Lopez, met with Licensee, Maria Fernandez, for an unannounced Required- 1 Year Inspection. LPAs were granted access to the home by the Licensee and toured both indoors and outdoors during the inspection. Upon arrival, there were six (6) children (two infants/ four preschool-age), the Licensee, and Assistant (Maria A.) present, which is compliant with the home license capacity and ratio requirements. LPAs observed all required postings near the entrance to the home and the hours of operation are Monday – Friday, 6:00AM-6:00PM. The Licensee states that adults over the age of 18, residing in the home are: herself, her friend (Jorge), and her son (Oscar). All adults residing in the home have Criminal Background Check Clearance and proof of negative tuberculosis (TB) test. The 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. LPAs reviewed facility roster (LIC9040) and fire/disaster drill log and observed the last drill was conducted on 2/17/2023, which is compliant with the six-month requirement for homes. LPAs observed a fully charged 3A40BC fire extinguisher (last serviced: 2/2023), functioning smoke detector and carbon monoxide detector. The Licensee states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. There are no weapons or firearms in the home. 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 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

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023

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: 444410310
	VISIT DATE: 03/08/2023

NARRATIVE

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Indoor areas of the home were inspected by the LPAs and observed to be clean, orderly, and safe for the day care children. During today's inspection LPAs observed the Licensee and Assistant engaged in various activities with the children such as circle time and arts/crafts. Off-limits areas inside the home: 3 bedrooms and attached garage. There is a fully barricaded/ non-functional fireplace located in the living room. The Licensee states that she works with Pajaro Valley Unified School District and Go Kids programs. Food is served to the children through Community Bridges Food Program and the Licensee states that she serves AM snack, breakfast, and lunch. The bathroom in the home is clean, sanitary, and operable. There is a working telephone in the home.

The backyard area of the home was inspected and observed to be fenced in. LPAs observed sufficient play-equipment and supplies for the children. Off-limit areas outside the home include: both side yard areas. No outdoor bodies of water were observed during todays inspection.

Five (5) children files were reviewed during todays inspection and all required documents were present, including Individual Infant Sleep Plan (LIC9227) and sleep check documentation for all infants. The Licensee and Assistant files were reviewed and all required documents were present. The Licensee has current CPR/First-Aid that expires 2/9/2025 and current Mandated Reporter Training that expires 12/2/2023 and LPAs reminded that training must be renewed every 2 years.

The Licensee states that she may transport day care children in case of emergency and LPAs confirmed she has a valid CA drivers license, current car registration and vehicle insurance. LPAs reminded Licensee that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Exit interview conducted and report was reviewed with the Licensee, Maria Fernandez.

As a result of todays inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023

LIC809 (FAS) - (06/04)

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