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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274415989
Report Date: 10/02/2024
Date Signed: 10/02/2024 04:14:19 PM

Document Has Been Signed on 10/02/2024 04:14 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:RAMIREZ PEREZ, CARLOSFACILITY NUMBER:
274415989
ADMINISTRATOR/
DIRECTOR:
CARLOS RAMIREZ PEREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 214-4846
CITY:SALINASSTATE: CAZIP CODE:
93907
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 8DATE:
10/02/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:25 PM
MET WITH:Carlos Ramirez PerezTIME VISIT/
INSPECTION COMPLETED:
04:25 PM
NARRATIVE
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At 1:25 PM, Licensing Program Analyst (LPA) Fermin Campos-Jaramillo met with licensee's helper Margarita Narez. Licensee Carlos Ramirez Perez arrived later at 1:40 PM, for an annual inspection and explained the reason for the visit to them. Present during today's visit were licensee's helpers Margarita Narez Tapia and Julian R Vasquez Tapia, with one infant, one school age and 7 preschool age children. Licensee stated he is the only adult residing in the home. Days and hours of operation are Monday through Sunday 12:00 AM to 11:59 PM.

LPA inspected inside and outside of the home. LPA observed a blocked fireplace, no wall heater, no stairs, and no bodies of water. Licensee stated there are no weapons and no pets in the home. LPA observed a fully charged 3A40BC fire extinguisher. Carbon Monoxide detector and smoke detectors were operable. Sharp objects, medicines, poisons and cleaning supplies are inaccessible to the children and stored in the garage and top kitchen cabinet. Backyard is fenced. Off limit areas: two bedrooms, one bathroom, garage, shed, right and left side yards.

Children were supervised during the visit and LPA went over substitute options and reminded licensee on license capacity and ratio. Licensee stated they do transport children, LPA reminded Licensee that children are never to be left in parked vehicles and must use appropriate car seats according to the child's age/weight/size.



LPA took a picture of the roster of the children. LPA observed a fire and disaster drill log that was last documented on 4/13/24. LPA reviewed 5 children’s files and observed all required documentation was in compliance. LPA observed that the Licensee and helpers Margarita and Julian have current Mandated Reporter training expiring on 3/30/25, 3/30/25, and 5/22/26 respectively. Licensee has Pediatric CPR/firstAid expiring 2/21/25 and helpers Margarita on 2/7/25 and Julian on 2/21/25. Licensee provided with documentation for SB 792 which requires immunization against Pertussis, Measles, and Influenza.

Continues on report dated 10/02/24

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 10/02/2024 04:14 PM - It Cannot Be Edited


Created By: Fermin Campos-Jaramillo On 10/02/2024 at 02:59 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: RAMIREZ PEREZ, CARLOS

FACILITY NUMBER: 274415989

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 10/02/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation the licensee did not comply with the section cited above, Helper Julian Vasquez Tapia was present and in contact with the children in care, although Julian is cleared and associated to another facility, he is not associated as of today to this facility, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/03/2024
Plan of Correction
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Licensee shall immediately associate helper Julian Vasquez Tapia to this facility no later than 10/03/24 close of business. AB633 forms and requirements were explained to licensee. Civil penalties were assessed today for a total of $500.00
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Susy Cervantes
LICENSING EVALUATOR NAME:Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2024


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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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: RAMIREZ PEREZ, CARLOS
FACILITY NUMBER: 274415989
VISIT DATE: 10/02/2024
NARRATIVE
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Continuation of report dated 10/02/24
A review of staff records on 10/01/24 indicates that not all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA observed that helper Julian is not associated to the license as of today 10/02/24

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-and-resources/safe-sleep as an additional resource.


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: http://www.ada.gov/childqanda.htm

***********************Report dated 10/02/24 continues on page 3.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
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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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: RAMIREZ PEREZ, CARLOS
FACILITY NUMBER: 274415989
VISIT DATE: 10/02/2024
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******************Report dated 10/02/24 continues from page 2
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 Carlos Ramirez Perez confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.


LPA discussed the requirements of AB633 to licensee. LPA provided him the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) both in English and Spanish and licensee stated he understands the requirements. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

One Type A deficiency was cited during today's visit.
Licensee 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 licensee, Carlos Ramirez Perez. 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: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
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