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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274450073
Report Date: 06/04/2024
Date Signed: 06/04/2024 11:35:40 AM

Document Has Been Signed on 06/04/2024 11:35 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MENDOZA, FELICITASFACILITY NUMBER:
274450073
ADMINISTRATOR/
DIRECTOR:		FELICITAS MENDOZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 536-5243
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
06/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:13 AM
MET WITH:Felicitas MendozaTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Licensing Program Analysts (LPAs), Cortney Nelson and Jennifer 'Jen' Beehler, met with Licensee, Felicitas Mendoza, for an Annual/Random Inspection. LPAs were granted access to the home by the Licensee and toured both indoors and outdoors during the inspection. Upon arrival, there were ten (10) preschool-age children, the Licensee, and her Assistant (S2) present, which is compliant with the home license capacity and ratio requirements. LPAs observed all required postings near the entrance to the home and the hours of operation are Monday – Friday, 6:00AM-6:00PM.

Licensee states that adults, over the age of 18, residing in the home are: herself, her spouse (Gustavo), her sons (Ismael & Adrian), and her daughter (Valeria). All adults residing in the home have Criminal Background Check Clearance and proof of negative TB test.

Licensee was 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.

LPAs reviewed facility roster (LIC9040) and fire/disaster drill log during todays inspection. The last fire drill was conducted on 5/14/2024, which is compliant with the six-month requirement for homes. LPAs observed a fully charged 3A40BC fire extinguisher, functioning smoke detector and carbon monoxide detector. 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. The Licensee states that there are no weapons or firearms in the home.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2024
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: MENDOZA, FELICITAS
FACILITY NUMBER: 274450073
VISIT DATE: 06/04/2024
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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/.

Indoor areas of the home were inspected by the LPAs today and observed to be clean, orderly, and safe for the day care children. During today's inspection, LPAs observed children engaged in making cheerios necklaces and playing outside. Off-limits inside the home include: two (2) bedrooms. The home has two wall heaters in the home that are barricaded and safe for the children. LPAs observed sufficient age-appropriate materials, toys, and play equipment in the home. The bathroom in the home is clean, sanitary, and operable. The Licensee has a working telephone (cellphone).

The backyard area of the home was inspected and observed to be fenced in. LPAs observed sufficient play-equipment and supplies for the children that are in good condition and age-appropriate. There is a sandbox, library, drama/kitchen area, blocks, music, art areas, and riding bikes. Off-limit areas outside of home include: detached apartment and storage area. No outdoor bodies of water were observed during todays inspection.

Five (5) children’s files and the staff files were reviewed and all required documents were present. LPAs reminded that all adults working with the children, including the Licensee's adult children, shall have all required personnel paperwork. The Licensee has current CPR/First-Aid that expires 2/28/2025 and current Mandated Reporter Training that expires on 4/25/2025. LPAs reminded that training must be renewed by all staff every 2 years.

The Licensee states that she does not transport any day care children. LPAs 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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
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: MENDOZA, FELICITAS
FACILITY NUMBER: 274450073
VISIT DATE: 06/04/2024
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The Licensee states that she works with Migrant Head Start and Community Bridges Food Program. Children in care are served breakfast, lunch, and AM/PM snack.

Licensee was 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.

During the exit interview, the Licensee, Felicitas Mendoza, confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

Exit interview conducted and report was reviewed with the Licensee, Felicitas Mendoza.

As a result of todays inspection, no deficiencies were cited.

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.

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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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