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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274411540
Report Date: 08/03/2022
Date Signed: 08/03/2022 11:56:00 AM

Document Has Been Signed on 08/03/2022 11:56 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:REYNOSO, ROSAISELAFACILITY NUMBER:
274411540
ADMINISTRATOR:REYNOSO, ROSAISELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 580-7032
CITY:SALINASSTATE: CAZIP CODE:
93905
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
08/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Rosaisela ReynosoTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Fermin Campos-Jaramillo conducted an unannounced inspection with the purpose of reactivate the license. LPA met with licensee Rosaisela Reynoso. Days and hours of operation will be Monday to Friday from 6:00 AM to 6:00 PM. Licensee stated the adults that reside in the home are herself, and her spouse Jose Gonzalez. Licensee stated also in her home resides her minor children ages 10 and 3 year old. LPA observed licensee's minor children were present during the inspection. Licensee certification for CPR and First Aid will expire on 7/26/24.

LPA toured the interior and the exterior of the one story home.
Licensee stated off limit areas inside the home are three bedrooms, one bathroom, and the attached garage. Licensee stated off limits area outside is the left side yard. LPA observed the home has a fenced back yard. Licensee uses the back yard as playground for the children in care. LPA observed there are not stairs inside the home.
LPA observed a fully charged 2A10BC fire extinguisher last serviced on 7/26/22, working smoke and carbon monoxide detectors, and no bodies of water. The Licensee states that she does not have any weapons in the home. Licensee understands that all kind of detergents, cleaning compounds, medications, and other similar items must be stored inaccessible to children. LPA observed there are not wall heaters in the home. Licensee stated she does not have any pets. LPA observed a barricaded fireplace in the on limits living room.
Licensee has submitted to this Department proof of having immunization for pertussis, measles, and influenza according with the SB792.

A review of staff records on 7/28/22 indicates that all the adults in the home or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Report dated 8/03/22 continues on page 2.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE: DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/03/2022
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: REYNOSO, ROSAISELA
FACILITY NUMBER: 274411540
VISIT DATE: 08/03/2022
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Report dated 8/03/22 continues from page 1.

The Licensee understands her capacity options and she understand she cannot have more than 14 children in the home at any time. Licensee understands her own children until they reach the age of ten, count as part of the capacity of her license.

Licensee states that she will be available for transporting children via vehicle and she understands that children cannot be left in parked vehicles unattended at any time.

Department website: www.ccld.ca.gov provided to Licensee.


LPA observed Licensee has completed the "mandated reporter" training on 7/25/22 Licensee is aware of renewing the training every two years. LPA referred the Licensee to the training website: www.mandatedreporterca.com for additional information on the online training.
LPA reviewed with licensee about the new regulations on safe sleep for infant children. LPA referred the licensee to the Department website: www.ccld.ca.gov and provided licensee with a form LIC9227.

No deficiencies have been cited. License will be reactivated as of today.

A NOTICE OF SITE VISIT WAS PRINTED AND MUST BE POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022
LIC809 (FAS) - (06/04)
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