444414720-7-15-2022-07-CC-EBEN-CGBTGX-20220714144352

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444414720
Report Date: 07/14/2022
Date Signed: 07/15/2022 08:37:55 AM

Document Has Been Signed on 07/15/2022 08:37 AM - 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:	MONTANEZ, ROSALBA		FACILITY NUMBER:	444414720
ADMINISTRATOR:	MONTANEZ, ROSALBA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 536-5919
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	07/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:02 PM
MET WITH:	Rosalba Montanez		TIME COMPLETED:	03:00 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 Celi Almaraz conducted an unannounced Required – 1 year annual inspection. Licensing staff present during inspection wore appropriate personal protective equipment. LPAs were granted access to the home by Licensee's assistant, Alicia Montanez and explained the nature of today's inspection. Present during todays inspection were the Licensee Rosalba Montanez and assistant. This is a Large Family Child Home Day Care. Licensee was operating within capacity and ratio requirements. LPAs also observed seven day care children (1 infant & 6 preschoolers) in the home during today's inspection. LPAs 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. There are four adults residing in the home (criminal record clearances on file). Licensee, spouse Ramiro Rocha, sons Rodrigo Rocha and Ramiro Rocha Jr. and one minor 15 year old son. Physical Plant: This is a mobile home which consists of four bedrooms and two bathrooms, a kitchen, living room, dinning room area and a laundry room. LPAs inspected the indoor and outdoor areas of the home today. Per licensee off limit areas in the home are as follows: Four bedrooms (one master), laundry room (used as an emergency exit only) and one bathroom, in the master bedroom. Off limit areas outside the home are as follows: Rear right side (where gym equiptment is stored). There is an outdoor play area that is fully gated. LPAs inspected this area and observed it is safety compliant. Per licensee there are no bodies of water inside or outside of the home. During this inspection, the following was also noted: At 1:01 PM, LPAs began tour through the interior of the home, during nap time. Napping equipment was observed to be safe and clean. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and central heating for safety and comfort. There were safe toys, play equipment and materials observed for children. LPA did not observe any hazards inside of the home. There is a working telephone service maintained in the home. 1/3

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022

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 3

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: MONTANEZ, ROSALBA	FACILITY NUMBER: 444414720
	VISIT DATE: 07/14/2022

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
26
27
28
29
30
31
32

Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible and some items are stored in off limits laundry room. The licensee states that there are no poisons in the home. The licensee does understand that poisons must be locked with a key or combination lock. Licensee states that there is one weapon in the home. LPAs observed the firearm is kept in a locked box, with a safety lock on the firearm, kept within a combination safe, in off limits room, which has a safety knob on the door. Per licensee there is currently no ammunition in the home. LPAs did not observe any bodies of water inside or outside the home. Per licensee there are no pets in the home. Per licensee, they do not transport children in care.

Fire Safety: LPAs observed the following: 1. A 2A10BC fire extinguisher last serviced 07/01/2022. 2. Last fire drill was conducted on 07/12/2022. 3. There are no heaters in the home. 4. There is no fireplace or similar item in the home. 5. There is a working smoke and carbon monoxide detector in the home. Per licensee there is no smoking in the home.

LPAs observed and inspected sleeping equipment for infants. LPAs observed one crib for the infant. All equipment meets the US Consumer Product Safety Commission safety standards. Please see www.safekids.org for a list of any recalled products. LPAs observed that cribs are free from loose articles and hanging or similar objects. LPAs observed that crib do not hinder the entrance or exit to and from the space they are sleeping in. Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Infant has individual bedding. LPAs discussed bedding shall be washed at least once weekly. Soiled bedding is replaced when wet or soiled and is placed in an area inaccessible to infants. Pacifiers were not observe. Licensee understands there is not be attached to anything. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping.

Facility Records: Licensee has the following: 1. Licensee has CPR and First Aid, valid through 03/13/2023. 2. Licensee has MMR & Tdap vaccinations, as well as opt out for flu vaccine. 3. A current roster. 4. Licensee stated there is day care insurance, DCI. 5. Mandated Reporter Training, valid for licensee through 03/10/2024 and understands this must be renewed every two years. LPAs observed staff files were complete. LPAs issued the Review of Staff records (LIC 859) to the Licensee during this inspection. LPAs also reviewed seven children's complete files and observed current and updated Children’s Record Review (LIC 857) and immunization records and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A) in each file. As well as one infant safe sleep plan. 2/3

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: MONTANEZ, ROSALBA	FACILITY NUMBER: 444414720
	VISIT DATE: 07/14/2022

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
26
27
28
29
30
31
32

LIC 9227 (Individual Sleeping Plan) for infants up to 12 months in files. Title 22 Regulation Section 102425(j) Infant Safe Sleep was discussed with the Licensee, including but not limited to documentation that shall be maintained.

Incidental Medical Services (IMS) policy was discussed. Per Licensee there are currently no children enrolled who required IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) 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 . LPAs observed a lock box for medication in the event one is needed.

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. LPA also informed the 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

Exit interview conducted and report was reviewed with the Licensee. No deficiencies issued during today's inspection.

NOTICE OF SITE VISIT ISSUED AND MUST REMAIN POSTED FOR 30 DAYS. 3/3

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3