274412878-9-7-2023-07-CC-FCJO-CVFSPV-20230907140347

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274412878
Report Date: 09/07/2023
Date Signed: 09/07/2023 02:03:53 PM

Document Has Been Signed on 09/07/2023 02:03 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:	HERNANDEZ, ANGELICA		FACILITY NUMBER:	274412878
ADMINISTRATOR:	HERNANDEZ, ANGELICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 759-9383
CITY:	SALINAS	STATE: CA	ZIP CODE:	93905
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	09/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Angelica Hernandez		TIME COMPLETED:	02:15 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 Analyst (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection to the home today. LPA met with Angelica Hernandez, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Saturday from 5:00 AM to 6:00 PM. The adults that reside in the home are the Licensee, her spouse Miguel, her sons Miguel and Gustavo. Licensee's helpers Miguel (spouse), and her sons Miguel and Gustavo were present. LPA observed ten children in care during today's inspection, included one infant and nine pre-school age. Licensee Certifications for CPR and First Aid card are current an will expire on 01/21/2024 for licensee and on 9/13/23 for her helper Miguel. LPA toured the indoor and outdoor areas of the home during today's inspection. LPA obtained a copy of children's roster and it is current. Licensee has documented a fire drill during the last six months. Last fire drill was documented on 8/04/23. LPA reviewed five children's files and observed that parent's rights forms, immunization records forms, consents for emergency medical treatment forms, and Identification and emergency information forms are in each file. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas inside are: All the second floor and the laundry area and the garage in the first floor. LPA observed there are barricaded stairs in the home. The home has a fireplace and it is barricaded. Off limits areas outside: The right side yard. LPA observed the back yard is fenced. Licensee uses the back yard as playground for the children in care. LPA observed a fully charged 3A40BC fire extinguisher, and working smoke detectors. LPA observed the home has at least one working carbon monoxide detector and no bodies of water. The Licensee states that she does not have any weapons in the home. LPA reminded licensee that all detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. The licensee has in file proof of having immunization for measles, pertussis and influenza for herself and for her helpers. **************Report dated 9/07/23 continues on page 2

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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: HERNANDEZ, ANGELICA	FACILITY NUMBER: 274412878
	VISIT DATE: 09/07/2023

NARRATIVE

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***********Report dated 9/07/23 continues from page 1.

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. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time, ratio (age of the children) must be observed, and a helper must be present whenever there are more than 8 children in care. Licensee understands that her license's capacity is reduced to only 8 if a helper is not present in the home, and ratio must be observed as well. The Licensee states that her spouse and helper transports children via vehicle and they understand that children cannot be left in parked vehicles unattended at any time. Licensee uses redirection and communication with children as a form of discipline.
Department website: www.ccld.ca.gov provided to Licensee.
Licensee's mandated reporter training was renewed on 7/14/23 for herself and for her two helpers, spouse Miguel and son Miguel. Licensee understands the training shall be renewed every two years and it is now available in Spanish. LPA referred the Licensee to the Department website: www.mandatedreporterca.com for additional information on the online training.

A review of staff records on 8/29/23 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
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 discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource.

Report dated 9/07/23 continues in page 3

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC809 (FAS) - (06/04)

Page: 2 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: HERNANDEZ, ANGELICA	FACILITY NUMBER: 274412878
	VISIT DATE: 09/07/2023

NARRATIVE

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********************Report dated 9/07/23 continues from page 2.

LPA also informed 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.

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/.

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.

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 Angelica Hernandez 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 Angelica Hernandez.

No deficiencies were cited today.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC809 (FAS) - (06/04)

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