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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274450009
Report Date: 06/13/2024
Date Signed: 06/13/2024 03:24:26 PM

Document Has Been Signed on 06/13/2024 03:24 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:REYES, ADRIANA & GONZALEZ, GAUDENCIAFACILITY NUMBER:
274450009
ADMINISTRATOR/
DIRECTOR:		REYES & GONZALEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 759-2379
CITY:SALINASSTATE: CAZIP CODE:
93901
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 6DATE:
06/13/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Adriana Reyes & Gaudencia GonzalezTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
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Licensing Program Analyst (LPA) Martha Jimenez-Villanueva met with Licensees Adriana Reyes & Gaudencia Gonzalez for an unannounced Inspection on June 13, 2024, at 1:00pm. LPA explained the nature of today’s inspection to them. Present during today's visit were Licensees and 6 children in care: three infants, one toddler, one preschooler and one schooler. Adults living in the home are Licensees and Adriana’s husband. Days and hours of operation are Monday through Friday from 7:30 AM to 5:30 PM.

A review of staff records on 05/21/2024 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensees were 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 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 at home. LPA observed a full fire extinguisher 3A40BC that was serviced on 07/12/23. Carbon Monoxide detector and smoke detectors were operable. Sharp objects, medicines, poisons and cleaning supplies are inaccessible to the children and stored in a top cabinet in the kitchen and in the garage. Backyard is fenced. Off limit areas: one bedroom, garage, and left side yard.

Report continues in LIC 809-C page 2
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: REYES, ADRIANA & GONZALEZ, GAUDENCIA
FACILITY NUMBER: 274450009
VISIT DATE: 06/13/2024
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Continues LIC 809-C page 2

LPA took a picture of a current roster of the children and a fire and disaster drill log which was last completed on 06/13/2024. LPA reviewed six children's files and observed all required documentation, including LIC 9227 and sleep log are completed and current. LPA observed LIC 282 on files. LPA observed that the Licensees have Mandated Reporter trainings completed on 11/08/2022 (both). Licensees have Pediatric CPR/1st Aid expiring 07/23/2024 (both). Needed documentation for SB 792 which requires immunization against Pertussis, Measles, and Influenza as well as TB testing are on file for licensees. LPA provide the website www.mandatedreporterca.gov


Supervision of children was discussed with licensees, and they understand that they must be present in the home during day care hours and ensure that the children are supervised at all times. Licensees understand their capacity options and they understand that they cannot have more than 14 children in the home at any time. Licensees understand in absence of a helper the capacity of their license is reduced in capacity and ratio to a small Family Child Care Home license, maximum 8 children. Licensees stated do not transport children, LPA reminded Licensees 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 discussed the safe sleep regulations with Licensees and discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

Report continues in LIC 809-C page 3
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: REYES, ADRIANA & GONZALEZ, GAUDENCIA
FACILITY NUMBER: 274450009
VISIT DATE: 06/13/2024
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Continues LIC 809-C page3

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: https://www.ada.gov/resources/child-care-centers/.


To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process

Licensees were 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.

Exit interview conducted and report was reviewed with the Licensees Adriana Reyes & Gaudencia Gonzalez in Spanish.


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

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: Belinda Devall
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
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