274416771-1-6-2023-07-CC-JMAS-CMTQGG-20230106110930

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274416771
Report Date: 01/06/2023
Date Signed: 01/06/2023 11:09:37 AM

Document Has Been Signed on 01/06/2023 11:09 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	CARROLL, JILL		FACILITY NUMBER:	274416771
ADMINISTRATOR:	JILL, CARROLL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 578-9970
CITY:	SALINAS	STATE: CA	ZIP CODE:	93908
CAPACITY:	14	CENSUS: 4	DATE:	01/06/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Jill Carroll		TIME COMPLETED:	11:00 AM

NARRATIVE

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Licensing Program Analyst (LPA) Joe Macias conducted an announced Prelicensing Inspection. The LPA met with the Applicant Jill Carroll and disused the nature of today's inspection. The purpose of today’s inspection is to ensure the home is in compliance with Title 22 California Code of Regulations. Todays census is 4, upon arrival LPA observed 4 children (1 infants, 3 preschool age) present, the Applicant will receive a deficiency for providing unlicensed care. Unlicensed care was discussed with the Applicant. The Applicant and her husband Barry Carroll are the only adults who reside in the home. The hours of operation are Monday - Friday, 8am - 5pm. The Applicant's CPR and First Aid are current, and expire May 2023. The Applicant has completed the Lead Poisoning Prevention Training. Applicant may obtain liability insurance upon receiving her license.

LPA toured the indoor and outdoor areas of the home during today's inspection. The Applicant has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the children in care. The home is orderly, and safe for the day care children. The LPA did not observe a wall heater in the home (central heat). The LPA observed a securely gated and locked fireplace in the home. The off limit areas inside the home are: all bedrooms (with the exception of bedroom #1), family bathroom, master bathroom, laundry room, back yard behind the home, and garage.

Prior to today's inspection LPA Macias received an approved fire clearance from Monterey County Regional Fire District. LPA observed a fully charged 2A10BC fire extinguisher, working smoke, and carbon monoxide detectors. The LPA observed a body of water. There is a securely locked and covered hot tub/ jacuzzi in the side yard. The hot tub/ jacuzzi is non-operable, and empty of water. The Applicant states that she does not have weapons in the home. All detergents, cleaning compounds, poisons, medications, and other similar items are out of reach and inaccessible to children. Applicant states that he does not plan on administering medications.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CARROLL, JILL	FACILITY NUMBER: 274416771
	VISIT DATE: 01/06/2023

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Applicant will be using effective communication, reflection time, and redirection as forms of discipline. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Discussed isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute. LPA informed Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

The LPA also reviewed the Child Care Program COVID-19 Self-Assessment check list with the Applicant.

LPA discussed the safe sleep regulations with the Applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

A review of staff records on January 6, 2023 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The Applicant Jill Carroll 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.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CARROLL, JILL	FACILITY NUMBER: 274416771
	VISIT DATE: 01/06/2023

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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 (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

The Applicant has completed the Mandated Reporter Training.

Type B deficiency cited for unlicensed care. Exit interview conducted and report was reviewed with the Applicant Jill Carroll. The Applicant was advised that a large family child care license will be issued pending management approval.

SUPERVISOR'S NAME: Gladys Kuizon	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR NAME: Joseph Macias	TELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

LIC809 (FAS) - (06/04)

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