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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444412162
Report Date: 01/18/2023
Date Signed: 01/18/2023 12:36:26 PM


Document Has Been Signed on 01/18/2023 12:36 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:LA CASITA INFANT TODDLER PROGRAMFACILITY NUMBER:
444412162
ADMINISTRATOR:ELIZABETH TAPIAFACILITY TYPE:
830
ADDRESS:412 EAST LAKE AVENUETELEPHONE:
(831) 226-3902
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY:12CENSUS: DATE:
01/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Sandra Nambo, Lupita Garcia, Lorena GonzalezTIME COMPLETED:
12:45 PM
NARRATIVE
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Licensing Program Analyst (LPA), Cortney Nelson, met with Teacher-Director, Sandra Nambo, Site Supervisor, Lupita Garcia, and Education Manager, Lorena Gonzalez, for an unannounced Required- 1 Year Inspection. LPA was granted access to the facility by Sandra and toured both indoors and outdoors during the inspection. Upon arrival, there were five (5) infants and three (3) staff members present, which is compliant with the facility license capacity and ratio requirements. LPA observed all required postings near the entrance to the facility and the hours of operation are Monday – Friday, 8:30AM-3:00PM.

LPA reviewed digital sign-in/out sheets, facility roster (LIC9040), and fire/disaster drill log during today’s inspection. The last fire/disaster drill was conducted on 12/9/2022, which is compliant with the six-month requirement for facilities. LPA observed a fully charged 3A40BC fire extinguisher, functioning smoke detector and carbon monoxide detector. The facility has children in care who require Incidental Medical Services and administers medication at this time. LPA observed that medication is properly stored out of reach of children with the proper documentation. LPA advised that prescription medication must have unaltered label, as prescribed hydrocortisone cream was observed today without original packaging from physician. There are no weapons or firearms on the premises.

This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Child Care Centers, Section 101173 and 101226. 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 SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023
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 4


Document Has Been Signed on 01/18/2023 12:36 PM - It Cannot Be Edited

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: LA CASITA INFANT TODDLER PROGRAM
FACILITY NUMBER: 444412162

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/18/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(1)(B)
Health-Related Services
(1) All prescription and nonprescription medications shall be centrally stored in accordance with the requirements specified below: (B) Each container shall have an unaltered label.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above for one infant with prescribed hydrocortisone cream without a physicans note or original pharmacy packaging, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/27/2023
Plan of Correction
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The Licensee will submit photo of original packaging for the hydrocortisone cream, indicating the pharmacy tag with child's name and physicians recommended use. A physicians note can be substituted if original packaging cannot be obtained. Proof to be submitted by 1/27/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023
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: LA CASITA INFANT TODDLER PROGRAM
FACILITY NUMBER: 444412162
VISIT DATE: 01/18/2023
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Indoor areas of the facility were inspected by the LPA today and observed to be clean, orderly, and safe for day care infants. Toys are safe and do not have sharp edges or small parts that may pose a choking hazard. Infant changing table was observed to be padded, within arms reach of a sink, in good repair and safe condition. There are cribs available for young infants that are free from loose articles. Infants in care today were observed to be transitioning to mats. The floors are clean and free of tripping hazards and waste containers have tight fitting lids.

All infants present today have current Needs and Services plan that has been updated at least quarterly. The Site Supervisor states that the infant feeding plan is updated monthly and all formula and bottles were observed to be labeled individually with the child’s name and the date.

LPA discussed the safe sleep regulations with the 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.

The outdoor area of the facility was inspected and observed to be fenced in. Due to recent rainy/stormy conditions in the area, the outside space is not being utilized as it is very wet. LPA advised checking materials for any mold or water damage that may have occurred as a result of the rain prior to resuming use of the outside area. Play equipment is in good condition, age-appropriate, and has sufficient resilient materials (rubber padding) to absorb falls. No outdoor bodies of water were observed during today’s inspection. Shaded rest area is provided by canopy.

Five (5) infant files were reviewed during today’s inspection and all required documents were present including documented nap checks. Three (3) staff files were reviewed and all required documents were present. LPA advised updating transcripts for staff. All staff members have current CPR/First-Aid and the Teacher-Director's expires 6/14/2023. The Teacher-Director has current Mandated Reporter Training that expires on 2/14/2024. LPA reminded Education Manager that the Mandated Reporter training must be renewed by all staff every 2 years.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023
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: LA CASITA INFANT TODDLER PROGRAM
FACILITY NUMBER: 444412162
VISIT DATE: 01/18/2023
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The Education Manager understands that the Teacher- Director shall be on the premises during the hours the center is in operation and that infants at the center shall be visually supervised at all times.

Exit interview conducted and report was reviewed with Site Supervisor, Lupita Garcia, and Education Manager, Lorena Gonzalez.

As a result of today’s inspection, a deficiency was cited, see 809-D.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

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 SeguraTELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney NelsonTELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4