274450182-9-22-2022-07-CC-FCJO-CJHSXL-20220922141607

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274450182
Report Date: 09/22/2022
Date Signed: 09/22/2022 02:16:14 PM

Document Has Been Signed on 09/22/2022 02:16 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 DE MELGOZA, MARIA I.		FACILITY NUMBER:	274450182
ADMINISTRATOR:	MARIA MELGOZA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 632-2936
CITY:	CASTROVILLE	STATE: CA	ZIP CODE:	95012
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 13	CENSUS: 5	DATE:	09/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Maria I Rocha de Melgoza		TIME COMPLETED:	02:30 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	Licensing Program Analysts (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection to the home today. LPA met with Maria Rocha de Melgoza, Licensee, and explained the nature of today's inspection to her. Licensee's days and hours of operation are Monday to Saturday from 6:00 AM to 6:00 PM. The adults that reside in the home are the Licensee, and her spouse Everardo. There were five children in care during today's inspection, included two infants and three preschool age children. Certification for CPR and First Aid Card for Licensee and her spouse (and helper) are current and will expire on 10/17/22. LPA toured the indoor and outdoor areas of the home during today's inspection. LPA obtained a copy of the children's roster today and it is current. Licensee documented a fire drill on 9/03/22. LPA reviewed five children's files and observed that parent's rights forms, immunization records forms, consents for emergency medical treatment forms, and Identification and emergency information forms are in each file. The Licensee has a working telephone in the home (land line). LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas inside are: Three bedrooms, one bathroom, and the attached garage. Off limits areas outside: The right side yard and a storage shed in the back yard. The home has a back yard and it is fenced, Licensee uses it as playground. LPA observed a fully charged 2A10BC fire extinguisher that was last serviced on 3/17/22 and at least one working smoke detector. LPA observed the home has a carbon monoxide detector. LPA observed there are not stairs or wall heaters. Licensee has an small dog in the right side yard and licensee stated it is vaccinated. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. According with the SB792, Licensee presented proof that she has immunization for herself and her husband for measles, pertussis and influenza and proof is in her personnel file. ************************************Report dated 09/22/22 continues in page 2.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

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 DE MELGOZA, MARIA I.	FACILITY NUMBER: 274450182
	VISIT DATE: 09/22/2022

NARRATIVE

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Report dated 9/22/22 continues from page 1.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time and a helper must be present. Licensee understands in absence of a helper the capacity of her license is reduced in capacity and ratio to a small Family Child Care Home license, maximum 8. The Licensee states that she does not transport children via vehicle and that she understands that children cannot be left in parked vehicles unattended at any time. Licensee uses redirection and communication with children as a form of discipline.

Department website: www.ccld.ca.gov provided to Licensee.

LPA observed that licensee and her helpers have renewed the mandated reporter training on 11/12/21
Licensee understands the training shall be renewed every two years and it is mandatory for all the adults in contact with children. LPA referred the Licensee to the training website: www.mandatedreporterca.com for additional information on the online training.
A review of staff records on 9/20/22 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 Maria Rocha de Melgoza 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.
LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

*******************************************Report dated 9/22/22 continues on page 3

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

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 DE MELGOZA, MARIA I.	FACILITY NUMBER: 274450182
	VISIT DATE: 09/22/2022

NARRATIVE

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Report dated 9/22/22 continuers from page 2.

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.

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

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Exit interview conducted and report was reviewed with the licensee Maria Rocha de Melgoza

No deficiencies have been cited today.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

LIC809 (FAS) - (06/04)

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