444410320-4-20-2023-07-CC-EBEN-CR3VAQ-20230420161619

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444410320
Report Date: 04/20/2023
Date Signed: 04/20/2023 08:53:00 PM

Document Has Been Signed on 04/20/2023 08:53 PM - 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:	MALDONADO, OFELIA		FACILITY NUMBER:	444410320
ADMINISTRATOR:	OFELIA MALDONADO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 786-0825
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 5	DATE:	04/20/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Ofelia Maldonado		TIME COMPLETED:	04:30 PM

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Licensing Program Analysts (LPA) Elizabeth Berumen met with Licensee, Ofelia Maldonado, for an annual inspection and explained the reason for the visit to her. There were five day care children present during this visit, (one infant, three preschoolers and one school age). Licensee's assistant, Maria Maldonado-Ortiz and Licensee's husband, Francisco Maldonado.
Days and hours of operation are Monday through Friday 6:00 AM to 6:00 PM.
Licensee states that the adults living in the home are, herself, her husband (Francisco Maldonado), granddaughter (Valerie Maldonado) Daughter (Maria Maldonado) daughter in law (Mayra Maldonado) son (Eric Maldonado) and step-granddaughter Valerie Leonor.
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.

LPA inspected inside and outside of the home. Off limit areas: three bedrooms, detached studio (garage) and two storage sheds in the backyard. LPA observed that both storage sheds were locked. LPA observed barricaded wall heater. No bodies of water. Licensee stated there are no weapons in the home. Licensee states she has a dog and has proof of vaccination. LPA observed a 2A10BC fire extinguisher that was serviced on 04/04/23. The Carbon Monoxide detector and smoke detectors were tested and proved to be functioning. Sharp objects, medicines, poisons and cleaning supplies are inaccessible to the children and locked. Backyard is fenced and safe for children. There is a detached studio on the property where Eric and Mayra Maldonado live. The home has a working telephone number; Licensee provided her cell number (831) 234-3526. LPA reminded Licensee of capacity options and assistant requirements. Licensee states she does not transport children, LPA reminded Licensee that children are never to be left in parked vehicles and must use appropriate car seats according to the child's age/weight/size.

Continues on report dated 04/20/2023.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

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: MALDONADO, OFELIA	FACILITY NUMBER: 444410320
	VISIT DATE: 04/20/2023

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Continuation of report dated 04/20/23
LPA obtained a copy of a current children roster. LPA observed a fire and disaster drill log that was last conducted on 04/04/23. LPA observed that the Licensee has Mandated Reporter training, training was completed on 02/21/22. Licensee has Pediatric CPR/1^st Aid expiring 01/26/25. Required immunization's against Pertussis and Measles. Licensee has a signed declination of influenza (flu) vaccine. LPA reviewed 5 children files and assistant (Maria Maldonado-Ortiz) file. Maria has current cpr & first aid. Mandated reporter training was completed on 02/21/22.

Incidental Medical Services (IMS) policy was discussed with the licensee. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The licensee is not providing IMS at this time.

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-and-resources/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.

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.

No deficiencies were cited during today's visit. Exit interview conducted and report was reviewed in Spanish with the licensee, Maria Maldonado.

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

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

LIC809 (FAS) - (06/04)

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