444410331-8-26-2021-07-CC-EBEN-C69ULT-20210826154116

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444410331
Report Date: 08/26/2021
Date Signed: 08/26/2021 03:41:44 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:	QUIROZ, LUZ		FACILITY NUMBER:	444410331
ADMINISTRATOR:	LUZ QUIROZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 724-3178
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 6	DATE:	08/26/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Luz Quiroz		TIME COMPLETED:	03:45 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 met with Licensee, Luz Quiroz for an unannounced Required – 1 year annual inspection (KIT 2). LPA was granted access to the home by the Licensee, Luz Quiroz. LPA observed six day care children (2 infant and 4 preschool aged children). Children were napping during the inspection. The 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 - Friday from 6:00 AM to 6:00 PM. Luz states there are five adults living in the home (Licensee, husband (Hector Quiroz), son (Hector Quiroz Jr) tenants, Yulisa Vasquez Zigala and Ruben Reyes. Licensee has a 14 year old daughter who lives in the home. Licensee update the LIC 279 today and provided to LPA to update people who live in the home. A review of staff records on August 10, 2021 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on 08/10/2021. The Licensee has the required vaccinations (MMR, Tdap, & flu) and is current with her Mandated Reporter Training for Child Care Workers. Licensee's CPR and First Aid certifications are current. Luz has Mandated Reporter Training for Child Care Workers. Luz understands that it is to be renewed every two years. Safe sleep update: LPA discussed the new “Safe Sleep” regulations with the Licensee and provided a copy of the regulations, including the Individual Infant Sleeping Plan (LIC 9227) form to the Licensee. LPA reminded the Licensee that infants up to 12 months of age must sleep on their backs, shall be supervised while they are sleeping, and documentation of sleep checks must be kept in each infant’s file.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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: QUIROZ, LUZ	FACILITY NUMBER: 444410331
	VISIT DATE: 08/26/2021

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Infants shall not be swaddled. There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards shall be free of loose articles and objects. LPA toured the indoor and outdoor areas of the home during today's inspection. The Licensee has a working telephone in the home; cell phone is (831)818-0479. LPA observed sufficient materials, toys, and play equipment for the day care children. The home is clean, orderly, and safe for the day care children. There is a wood burning stove in living room that is barricaded and off limit to children. LPA did not observe any wall heaters inside the home. Off limit areas in the home are three bedrooms and garage. Garage is converted into a room that Luz rents to tenant. Licensee reported today that she is going to construct a small home in her backyard. LPA informed her to submit updated facility sketch and a plan of how she plans to keep children safe. She states construction might be during her vacation. She understands she is to submit an updated facility sketch.
LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water, and fenced backyard. There is an empty water fountain in the off limits backyard area. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Any poisons are locked and inaccessible to the day care children. Licensee states no child requires medical treatment at this time.
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. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time without at least one fully qualified adult and a qualified assistant present in the home. The Licensee states that does not transport any day care children. The 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.
LPA conducted an exit interview with the Licensee and advised her that no deficiencies issued during today's inspection.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

LIC809 (FAS) - (06/04)

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