444412950-8-27-2019-07-CC-EBEN-BFFPYZ-20190827114443

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444412950
Report Date: 08/16/2019
Date Signed: 08/27/2019 11:46:25 AM

COMPREHENSIVE INSPECTION

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:	MENESES, MARIA		FACILITY NUMBER:	444412950
ADMINISTRATOR:	MENESES, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 728-3785
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 0	DATE:	08/16/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Maria Meneses		TIME COMPLETED:	11:30 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 Analyst (LPA), Elizabeth Berumen, conducted an annual random inspection. LPA met with Licensee, Maria Meneses and informed her of the nature of today's inspection. No day care children present during today's inspection. The day-care is open Monday thru Saturday from 6:00 AM to 6:00 PM. Adults living in the home are Licensee, her brother (Humberto Rojas), sister in law (Minerva Rojas) and Maurilio Guevarra Vasquez who is temporarily renting a room in the home. Maurillo has TB test and Criminal Record Clearance (LIC508). A review of staff records today indicate that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA inspected the indoor and outdoor areas of the home. LPA observed the following: fully charged 3A40BC fire extinguisher. LPA tested the smoke detector and carbon monoxide detector both proved to be functioning. Off limit areas in the home: 3 bedrooms and laundry room. The laundry room has an exit door. Maria lives in a mobile home and has a small gated patio she uses for outdoor play space. Licensee states that there are no weapons in the home and no pets in the home. Cleaning products, sharp objects, and other similar items are stored inaccessible to children. Cleaning products are stored in upper laundry cabinet inaccessible to children. Maria Meneses completed the Mandated Reporter Training on 01/27/18 and understands that she is to renew it every two years. Licensee has current CPR and First Aid certifications with an expiration date of 04/07/21. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 08/16/2019):

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

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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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: MENESES, MARIA	FACILITY NUMBER: 444412950
	VISIT DATE: 08/16/2019

NARRATIVE

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Licensee states she does not transport children via vehicle. LPA reminded her that children are not to be left in parked vehicles. When temporarily absent from the home, the licensee arranges for a substitute adults to care for and supervise children in their absence. Smoking is prohibited on the premises of a family child care home

LPA reminded Licensee that each child shall be accorded safe, healthful and comfortable accommodations, furnishings, and equipment. LPA reviewed facility roster and obtained a copy. LPA reviewed LPA reviewed fire disaster drill log; The home conducts fire and disaster drills at least once every six months, and documents the date and time of each drill. The last practiced drill was April 3, 2019.

LPA reminded licensee that any authorized employee of the Department may enter and inspect any place providing personal care and services at anytime, with or without advance notice.
Incidental Medical Services were discussed with the licensee. Maria Meneses states she does not provide incidental medical services.

Effective January 1, 2019, AB 2370, Chapter 676, Statutes of 2018, requires all child care providers, upon enrolling or re-enrolling any child, to provide the parent or guardian with written information including the following: Risks and effects of lead exposure. Blood lead testing recommendations and requirements. Options for obtaining blood lead testing, including any programs that offer free or discounted tests.

No deficiencies were cited during today's inspection. Exit interview was conducted with licensee in Spanish.

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: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

LIC809 (FAS) - (06/04)

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