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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274415989
Report Date: 01/25/2023
Date Signed: 01/25/2023 02:01:29 PM

Document Has Been Signed on 01/25/2023 02:01 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:RAMIREZ PEREZ, CARLOSFACILITY NUMBER:
274415989
ADMINISTRATOR:CARLOS RAMIREZ PEREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 214-4846
CITY:SALINASSTATE: CAZIP CODE:
93907
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
01/25/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Margarita Narez Tapia and Maria TapiaTIME COMPLETED:
02:15 PM
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On 01/25/2023 at 01:30 PM, Licensing Program Analyst (LPA) Susy Cervantes, met with assistants, Margarita Narez Tapia and Maria Tapia, for a case management visit in accordance with the requirements specified during an office visit on 11/16/2022. Present were assistants with 3 preschool age children. Assistants informed LPA that licensee, Carlos Ramirez Perez, was picking up school age children from school at this time. Shortly after LPA's arrival, Margarita Narez Tapia left to pick up her child from school.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 01/25/2023 was reviewed and it indicates that all Facility staff or other individuals who require caregiver background clearances 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, 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.

LPA reviewed assistant's, Maria Tapia, documents Mandated Reporter training was completed on 02/16/22, Pediatric CPR/1st Aid expiring 10/10/23. Needed documentation for SB 792 which requires immunization against Pertussis, Measles, and Influenza as well as TB testing is on file.

No deficiencies were cited during today's visit. Assistant was informed that failure to correct the deficiencies by the specified Plan of Correction Due Date will result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made. Exit interview conducted and report was reviewed in Spanish with the assistant, Maria Tapia. 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.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Susy Cervantes
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2023
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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