444415772-6-6-2024-07-CC-CNEN-D5YNXW-20240606105149

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444415772
Report Date: 06/06/2024
Date Signed: 06/06/2024 10:51:54 AM

Document Has Been Signed on 06/06/2024 10:51 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:	ANAYA, MARIA		FACILITY NUMBER:	444415772
ADMINISTRATOR:	ANAYA, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 295-3939
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY:	14	CENSUS: 3	DATE:	06/06/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:21 AM
MET WITH:	Maria Anaya		TIME COMPLETED:	11:01 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), Cortney Nelson, met with Licensee, Maria Anaya, for an unannounced Annual/Random Inspection. LPA was granted access to the home by the Licensee and toured both indoors and outdoors during the inspection. Upon arrival, there were two (2) preschool-age children and the Licensee present, which is compliant with the home license capacity and ratio requirements. One additional preschool-age child arrived prior to the end of todays inspection. LPA observed all required postings near the entrance to the home and the hours of operation are Monday – Friday, 6:00AM-6:00PM. Licensee states that adults, over the age of 18, residing in the home are: herself, her father (Ramon), her step-mother (Maria), her sister (Marisol), and her brother-in-law (Michael). All adults residing in the home have Criminal Background Check Clearance and proof of negative TB test. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. LPA reviewed facility roster (LIC9040) and fire/disaster drill log during todays inspection. The last fire drill was conducted on 5/6/2024, which is compliant with the six-month requirement for homes. LPA observed a fully charged 3A40BC fire extinguisher (last serviced: 1/2024), functioning smoke detector and carbon monoxide detector. Licensee states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. The Licensee states that there are no weapons or firearms in the home.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024

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: ANAYA, MARIA	FACILITY NUMBER: 444415772
	VISIT DATE: 06/06/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Indoor areas of the home were inspected by the LPA today and observed to be clean, orderly, and safe for the day care children. During today's inspection, LPA observed children engaged in circle time, singing songs, drawing, and playing with toys inside the home. Off-limits inside the home include: attached garage, living room, kitchen, three (3) bedrooms, one (1) bathroom, master bedroom and master bathroom. There is an open-faced heater in the home that is barricaded by a baby gate and safe for the children. Furniture, such as tables, chairs, and shelves, are in good condition and safe for children. The day care bathroom is clean, sanitary, and operable. The Licensee has a working telephone (cellphone).

The backyard area of the home was inspected and observed to be fenced in. LPA observed sufficient play-equipment and supplies for the children that are in good condition and age-appropriate. There is a wooden playhouse, kitchen area, art, blocks, painting, garden boxes, and functioning sink outside for children's use. Off-limits outside of the home include: storage area and wooden canopy area. No outdoor bodies of water were observed during todays inspection.

The Licensee states that she works with community bridges food program and serves the children in care breakfast, lunch, snack, and dinner.

Five (5) children's files and the Licensee's file were reviewed and all required documents were present. The Licensee has current CPR/First-Aid that expires on 1/21/2025 and current Mandated Reporter Training that expires on 1/14/2026. LPA reminded that Mandated Reporter training must be renewed by all staff every 2 years.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024

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: ANAYA, MARIA	FACILITY NUMBER: 444415772
	VISIT DATE: 06/06/2024

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The Licensee states that she does not transport any day care children. LPA reminded Licensee that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, Maria Anaya, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Exit interview conducted and report was reviewed with the Licensee, Maria Anaya.

As a result of todays inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Cortney Nelson	TELEPHONE: (916) 956-5037
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024

LIC809 (FAS) - (06/04)

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