274416854-11-21-2023-07-CC-SYIP-CXT2PV-20231121163455

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274416854
Report Date: 11/21/2023
Date Signed: 11/21/2023 04:34:59 PM

Document Has Been Signed on 11/21/2023 04:34 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:	ROCHA-ANAYA, FAVIOLA		FACILITY NUMBER:	274416854
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	11/21/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Faviola Rocha- Anaya		TIME COMPLETED:	11:50 AM

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) Samantha Yip conducted an announced pre-licensing inspection. LPA met with Applicant Faviola Rocha-Anaya and explained the reason for the inspection. The purpose of this inspection is Applicant is applying for a change of location. Applicant is currently licensed at 1533 Barcelona Circle, Salinas 93906. Present during today's inspection were Licensee, her fiancee, and her four minor children, whom one was infant age. There is a board to post required postings. The hours of operation are Monday through Saturday 6AM to 5:30PM. There is a working phone in the home. Applicant does have daycare insurance. LPA toured the inside and outside of the home with Applicant. The off-limit areas of the home are the laundry room, garage, and the entire upstairs. There are stairs in the home, which are barricade. There is also a fireplace in the home, which has a glass cover. There are toys and equipment for children. There is an infant chair similar to a baby walker in the living room, which cannot be in the home. Applicant moved the chair to an off-limit area. Applicant understands that baby bouncers or similar items are not allowed in the home. There is a fully charged fire extinguisher, smoke detector, and carbon monoxide detector. Applicant stated that there are no weapons, such as firearms, stored in the home. The backyard will be used and is fenced. The off-limit area outside is the right side of the home and the shed on the left of the home. There were no bodies of water observed during today's inspection. LPA discussed with Applicant about ensuring there is no gaps in the fence and that any shed with tools or other items that could pose a risk to children needs to be inaccessible to children. -------------------CONTINUES ON 809 DATED 11/21/2023 PAGE 2-------------

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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: ROCHA-ANAYA, FAVIOLA	FACILITY NUMBER: 274416854
	VISIT DATE: 11/21/2023

NARRATIVE

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---------------CONTINUATION OF 809 DATED 11/21/2023 PAGE 1-------------

LPA discussed the safe sleep regulations with 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 applicant 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. LPA discussed with Applicant that there cannot be anything in pack-n-play, such as toys and sheet needs to be tight-fitted.

Applicant does not plan on transporting children, but understands that children cannot be left alone and unattended in parked vehicles. The form of discipline Applicant plans on using is redirection and talking to the child.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

Applicant has a valid CPR/1st Aid, which expires on 05/13/2025. Applicant completed the Mandated Reporter training on 01/28/2022. Her immunization records for measles, pertussis, and flu are on file; along with her certificate for Preventive Health and Safety.

-----------------CONTINUES ON 809 DATED 11/21/2023 PAGE 3---------------

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ROCHA-ANAYA, FAVIOLA	FACILITY NUMBER: 274416854
	VISIT DATE: 11/21/2023

NARRATIVE

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--------------CONTINUATION OF 809 DATED 11/21/2023 PAGE 2---------------

Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

On this date, 11/21/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, 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.

LPA obtained a copy of the LIC 610, LIC 9151, and brief financial statement.

Applicant will submit the following by 12/01/2023:
- updated LIC 999 to reflect change to on-limit area
- Plan of Providing IMS

Exit interview conducted and report was reviewed with the applicant, Faviola Rocha-Anaya. Applicant was advised that review and approval of Licensing Program Manager that a license for a small family child care home will be issued.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC809 (FAS) - (06/04)

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