444414487-8-28-2019-07-CC-EBEN-BFGQ8B-20190828115628

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444414487
Report Date: 08/28/2019
Date Signed: 08/28/2019 11:56:39 AM

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:	LOPEZ DE ROSALES, OLIVIA		FACILITY NUMBER:	444414487
ADMINISTRATOR:	LOPEZ DE ROSALES, OLIVIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 728-1805
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 12	DATE:	08/28/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Juana Castro and Olivia Lopez de Rosales		TIME COMPLETED:	12:00 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 Analysts (LPAs), Elizabeth Berumen and Susy Cervantes, conducted an annual random inspection. LPAs met with Assistant, Juana Castro and Licensee, Olivia Lopez de Rosales and informed them of the nature of today's inspection. 12 children were present during today's inspection, 4 of which are infants. The day-care is open Monday thru Friday from 6:00 AM to 6:00 PM. Adults living in the home are Licensee, her husband (Ramualdo Rosales), and 3 daughters ages 17 (DOB 12/02), 14, and 12. LPA reminded Licensee to get fingerprints done for her eldest daughter when she turns 18. A review of staff records on 08/27/2019 indicate that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPAs inspected the indoor and outdoor areas of the home. LPA observed the following: fully charged 3A40BC fire extinguisher. LPA tested the dual smoke detector and carbon monoxide detector which proved to be functioning. Off limit areas in the home: 4 bedrooms, master bathroom and laundry room. The laundry room has an exit door. Olivia 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. LPAs observed one dog in a gated area in the yard. Cleaning products, sharp objects, and other similar items are stored inaccessible to children. Cleaning products are stored in upper laundry cabinet inaccessible to children. Olivia Lopes de Rosales and Juana Castro have Immunization against Pertussis and measles and have declined to get the influenza shot. Licensee stated that her assistant and herself have completed the Mandated Reporter training, however it was not available for review. Licensee and Assistant have current CPR and First Aid certifications with an expiration date of 02/2021 and 04/20/2020 respectively. REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 08/28/2019):

SUPERVISOR'S NAME: Mary Segura	TELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Elizabeth Berumen	TELEPHONE: (408) 318-1326
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019

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: LOPEZ DE ROSALES, OLIVIA	FACILITY NUMBER: 444414487
	VISIT DATE: 08/28/2019

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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

LPAs reviewed 12 children's files, all the files were complete. Licensee stated that she has liability insurance. 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 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 July 26, 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.
This facility currently provides Incidental Medical Services (IMS) for 2 children. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

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: 08/28/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2019

LIC809 (FAS) - (06/04)

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