274416745-10-26-2022-07-CC-ELAS-CKKUPP-20221026154552

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274416745
Report Date: 10/26/2022
Date Signed: 10/26/2022 03:46:13 PM

Document Has Been Signed on 10/26/2022 03:46 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:	RODRIGUEZ, HORTENCIA		FACILITY NUMBER:	274416745
ADMINISTRATOR:	HORTENCIA, RODRIGUEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 809-9472
CITY:	SALINAS	STATE: CA	ZIP CODE:	93905
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	10/26/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Hortencia Rodriguez		TIME COMPLETED:	03:45 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), Elizabeth Larios & Licensing Program Manager (LPM) Joel Segura, conducted an unannounced Required - 1 Year Inspection. LPA met with Licensee, Hortencia Rodriguez, and explained to her the purpose of today's visit. There were children present in the home. LPA observed all required posted materials. Days and hours of operation for the facility are Monday – Friday, 5:30 AM to 6:00 PM. Adult residing in the home: Licensee, and spouse. Licensee minor daughter also resides at the home. 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. Licensee has current children's roster and copy was obtained during the inspection. LPA observed: fully charged 2A10BC fire extinguisher, functioning smoke detectors, and working carbon monoxide detectors. Licensee states that there are no weapons in the home. Licensee states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual- Regulation Interpretations and Procedures for Family Child Care Homes, Section 102417. 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 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 Continuation on next page:

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022

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: RODRIGUEZ, HORTENCIA	FACILITY NUMBER: 274416745
	VISIT DATE: 10/26/2022

NARRATIVE

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LPA toured the home both indoor and outdoor. Off limit areas in the home: kitchen, dining area, family room, garage, and the entire second story of the home. The children's bathroom is clean, sanitary, and operable. Sufficient toys and play equipment for the children were observed. LPA observed that stairs are barricaded appropriately to keep day care children safe. The Licensee has a fireplace unit in the home that is not barricaded and safe for the children. Licensee understands that she cannot use the fireplace units during day care hours. Off limit areas outside the home: the entire backyard, front yard, and driveway. There were no bodies of water observed. All food is prepared by the Family Child Care Home and children are served AM/PM snacks, and lunch. The home has a working telephone which is (831) 809-9472.

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 reminded 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.

Children’s files were reviewed during todays inspection and all required documents were present, including Individual Infant Sleep Plan (LIC9227) and sleep check documentation for all infants under the age of 2 years old were not present for C-3. The Licensee's & assistant files was reviewed and all required documents were present. Licensee's Mandated Reporter Training certificate expires on September 20, 2023. LPA reminded Licensee that Mandated Reporter Training must be renewed every 2 years, website: www.mandatedreporterca.com. Licensee has current Pediatric CPR/First Aid certification with an expiration date of April 24, 2023. LPA reminded the Licensee that both training's must be renewed by all staff every 2 years.

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SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022

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: RODRIGUEZ, HORTENCIA	FACILITY NUMBER: 274416745
	VISIT DATE: 10/26/2022

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Supervision of children was discussed with the Licensee and she understands that she must be home during day care hours and ensure that children are supervised at all times. LPA reviewed capacity and staffing requirements for large family child care home with Licensee and provided copy of regulation (102416.5 Staffing Ratio and Capacity).The Licensee states that she does transport day care children. LPA reminded Licensee that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

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, Hortencia Rodriguez.

As a result of today's inspection, there was a deficiency cited and technical violations were also issued.

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: Joel Segura
LICENSING EVALUATOR NAME: Elizabeth Larios
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/26/2022 03:46 PM - It Cannot Be Edited

Created By: Elizabeth Larios On 10/26/2022 at 03:02 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: RODRIGUEZ, HORTENCIA	FACILITY NUMBER: 274416745
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/26/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102425(b)

Infant Safe Sleep

(b) Cribs or play yards shall be free from all loose articles and objects. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above. LPA & LPM observed that there was a blanket in the play yard while child (C-3) was napping, which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/27/2022
	Plan of Correction
1 2 3 4	Deficiency was corrected during today's inspection. Licensee removed blanket from child (C-3).

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Joel Segura

LICENSING EVALUATOR NAME:

Elizabeth Larios

LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022

LIC809 (FAS) - (06/04)

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