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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274403760
Report Date: 05/10/2023
Date Signed: 05/16/2023 05:02:34 PM

Document Has Been Signed on 05/16/2023 05:02 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:ROCHA, MARIAFACILITY NUMBER:
274403760
ADMINISTRATOR:ROCHA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 722-4192
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
05/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Maria RochaTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Elizabeth Berumen met with Licensee, Maria Rocha for an unannounced Required – 1 year annual inspection. LPA was granted access to the home by the Licensee. LPA also observed 6 napping day care children; 3 of which are infants. Assistant, Adriana Sanchez. Licensee was operating within her capacity and ratio requirements. LPA observed the required postings, including the facility license, near the front outdoor entrance to the home. Days and hours of operation are Monday - Friday from 6:00 AM to 6:00 PM. The adults residing in the home are: Licensee, Licensee's spouse (Jorge Luis Rocha), (son) Aldo Rocha, (granddaughter) Ilani Bohorquez. (son-in-law) Jesus Bohorquez. Adult tenants that live in the studio are Claudia Tarelo and Agustin Tarelo (and two minor children).

LPA reviewed a current Child Care Facility Roster and obtained a copy for facility file. LPA reviewed the Fire/Disaster drill log during today's inspection; last fire/disaster drill was completed on April 16, 2023. Licensee has day care insurance. Licensee has current CPR and First Aid certifications are current. Licensee has the required vaccines (MMR, Tdap, & flu) and is current with her Mandated Reporter Training for Child Care Workers expiring on 10/25/23. LPA reviewed assistants files (Adriana Sanchez), Assistant has immunization against pertussis, measles, mandated reporter training, tb test and CPR & First Aid.

LPA inspected the on limit indoor and outdoor areas of the home to ensure safety and compliance. Licensee has a working telephone in the home. The home is clean, orderly, (including central heating/ventilation), and safe for the day care children. There are safe & age appropriate toys, play equipment, and materials for the children in the home. LPA observed barricaded stairs. Off limit areas inside the home: entire upstairs (4 bedrooms and three bathrooms) downstairs off limit areas are bedroom, office, living room and kitchen. LPA notes that there are barricades to prevent access to those areas. Off limit areas outside: entire backyard. Licensee uses the front fenced area for play space.

LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors, no bodies of water. The fire extinguisher was serviced on February 2023. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Medication is stored in high kitchen cabinets inaccessible to children. Licensee was reminded that any poisons are to be locked and inaccessible to the day care children. Licensee states that she does not have any weapons in home.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
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: ROCHA, MARIA
FACILITY NUMBER: 274403760
VISIT DATE: 05/10/2023
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Licensee states that she provides meals (snacks and lunch) to the day care children. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored. Licensee has a first aid kit in the home which includes a touch less thermometer. Licensee understands that smoking is prohibited in the home. Licensee states that she does not administer any medications to the day care children at this time. Licensee is aware of the IMS plan required. Licensee states that a child will be isolated in a corner away from other children if necessary due to illness or communicable disease.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity/ratio options. Licensee states that does no transport day care children and she understands that children shall not be left unattended in parked vehicles. Licensee understands that car seats shall only be used for transportation and shall not be used for sleeping.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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, Maria Rocha. No deficiencies issued during today's inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
LIC809 (FAS) - (06/04)
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