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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434405068
Report Date: 06/30/2021
Date Signed: 06/30/2021 12:14:35 PM

Document Has Been Signed on 06/30/2021 12:14 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:SOTO, BLANCAFACILITY NUMBER:
434405068
ADMINISTRATOR:SOTO, BLANCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 786-8235
CITY:SAN JOSESTATE: CAZIP CODE:
95122
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
06/30/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Blanca SotoTIME COMPLETED:
12:25 PM
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LPA Deanna Villagrana met with licensee Blanca Soto a required 1 year visit. LPA explained the nature of today’s inspection to her. Present were licensee and licensee's son, 15 year old daughter and five daycare children. Days and hours of operation are Monday to Friday, 6:00am to 6:15pm. The adults that reside in the home are licensee, husband, two adult sons.

A review of staff records on 06/28/2021 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 understands upon notice of the Department to remove an individual from the home, or to exclude an individual from the home, the licensee shall immediately remove the individual and prevents them from returning to the home or having contact with children in care.

LPA toured the indoor and outdoor areas of the home during today’s inspection. LPA observed that the home is clean and orderly, with heating and ventilation for safety and comfort of the children. LPA observed a barricaded fireplace and wall heater in the home. LPA observed safe and sufficient materials, toys, and play equipment for the day care children. All sharp objects, detergents, cleaning compounds, medications, poisons, and other similar items inside the home are stored inaccessible to children. LPA observed a fully charged 3A40BC fire extinguisher. LPA observed a working combo smoke and carbon monoxide detector. LPA observed six rifles and one pistol in a locked safe in a locked closet in an off limits room. All guns had a safety lock attached. Ammunition is kept separate in a locked storage. Off limit areas indoor: Master bedroom/bath, one bedroom, and laundry room located in licensee's bedroom. There are no bodies of water. Backyard is fenced. Off limits outdoor: Locked storage. LPA observed one dog in the home. LPA observed licensee has a current CPR and First Aid certification expiring 10/26/2021 and completed Mandated Reporter training on 02/08/2020.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2021
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: SOTO, BLANCA
FACILITY NUMBER: 434405068
VISIT DATE: 06/30/2021
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LPA observed a current roster of the children and a fire and disaster drill log which was last completed on 02/17/2021. LPA reviewed five children's files and observed all forms are completed and children have current immunization records. LPA observed the daycare is insured with DCI and expires on 10/23/2021. LPA discussed SB792 Immunization Requirements and observed licensee has current immunization records on file.

Supervision of children was discussed with 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. Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time. Licensee understands if she transports children via vehicle, children cannot be left in parked vehicles unattended at any time.

LPA discussed Zero Tolerance with $500 immediate civil penalty. An ongoing $100 per day per violation continues until the violation(s) is corrected. LPA discussed the requirements of AB633 to licensee and provided her the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and licensee understands the requirements. Incidental Medical Services were discussed with the licensee. The licensee is not providing IMS (Incidental Medical Services) at this time. Licensee will submit an updated plan of operation if in the future they provide any IMS services to a child in care.

No deficiency was cited.

Notice of site visit was issued and must be posted for 30 days.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Deanna Villagrana
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021
LIC809 (FAS) - (06/04)
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