274418077-4-7-2026-07-CC-MJVA-DSWUS7-20260407154953

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274418077
Report Date: 04/07/2026
Date Signed: 04/07/2026 03:50:01 PM

Document Has Been Signed on 04/07/2026 03:50 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:	LAZARO CRUZ, KARINA		FACILITY NUMBER:	274418077
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 7	CENSUS: 3	DATE:	04/07/2026
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:30 PM
MET WITH:	Karina Lazaro Cruz		TIME VISIT/ INSPECTION COMPLETED:	04:00 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	On 04/07/2026, Licensing Program Analyst (LPA) Martha Jimenez-Villanueva made an unannounced Case Management Inspection in response to a request to increase the capacity from 8 to 14 children. LPA met with Licensee, Karina Lazaro Cruz and explained the nature of today’s inspection to her. Present were licensee and her own son (13 years old) with three children in care - one infant and two preschool age. Hours of operation: Monday to Friday, from 4:00AM to 5:30PM. LPA verified all required postings. The home received a Fire Inspection Clearance granted on April 2, 2026, by City of Salinas Fire Department. Fire pull station is near exit door in the family room. The following areas are approved for childcare according to the Fire Inspection document: family and living room, one bathroom, and entire backyard including a covered porch. The left side yard approved for emergency exit route. There is no special condition listed per fire clearance approval. The kitchen area is gated. Licensee understands the on limits and off-limits areas have been approved by the Fire District Authority and before making any changes to the use of the areas Licensee will notify the Licensing Program. Licensee does not carry insurance for child care at this moment, If a Large FCCH is approved she will obtain one. LPA inspected the indoor and outdoor areas of the home. LPA observed a fully 3A40BC fire extinguisher, serviced on 04/01/2026, functioning smoke detector and carbon monoxide detector, no stairs, no wall heater, no bodies of water, blocked fireplace in the home. LPA observed a fire drill was conducted on 02/11/2026. Off limits areas are master bedroom with bath and closet, 2 bedrooms, attached garage, right side yard (gated). The backyard is fenced. Licensee stated there are no pets in the home. Licensee states there are firearms in the home stored in off limits areas. Firearm is stored in a locked gun safe. The ammunition is stored separately in a locked safe. LPA verified at least two emergency exits that are clear for use. LPA asked if she had made any changes to the home after the fire clearance inspection, to which she answered no. Report Continues in next page.

NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Martha Jimenez-Villanueva
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: LAZARO CRUZ, KARINA	FACILITY NUMBER: 274418077
	VISIT DATE: 04/07/2026

NARRATIVE

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Licensee stated that she transports day care children. LPA reviewed licensee driver license, registration and insurance car, these documents are current. Licensee understands that children shall not be left unattended in parked vehicles must use appropriate car seats according to the child's age/weight/size and car seat cannot be used for sleeping.

Licensee understands that she must be present in the home during day care hours (80% of the operating hours). Licensee understands her current capacity options and she understands if eventually she obtains a large license with capacity 14, she cannot have more than 14 children in the home at any time and a qualified assistant must be present and ratio (age of the children) must be observed. Licensee understands in absence of a helper her license capacity is reduced to 8 and ratio must be observed as well. LPA reviewed and provided the capacity worksheet to licensee.

Roster report dated 04/07/2026 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee was reminded that all the 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.

During the exit interview, the LICENSEE Karina Lazaro Cruz confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were cited during the visit. 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. Appeal rights were handed to the licensee.
Exit interview conducted and report was reviewed with the licensee Karina Lazaro Cruz in Spanish and advised her that a large Family Child Care Home license will be approved as April 7, 2026, and will receive the license by postal mail.

NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Martha Jimenez-Villanueva
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2026

LIC809 (FAS) - (06/04)

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