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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406156
Report Date: 01/08/2025
Date Signed: 01/10/2025 10:29:55 AM

Document Has Been Signed on 01/10/2025 10:29 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SANDOVAL, VERONICAFACILITY NUMBER:
444406156
ADMINISTRATOR/
DIRECTOR:		VERONICA SANDOVALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 587-9289
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 4DATE:
01/08/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:07 AM
MET WITH:Veronica SandovalTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On January 8, 2025 at 9:07 AM, Licensing Program Analysts (LPAs) Darnella Barnes and Marilou Monico conducted an unannounced Annual Required inspection at the residence of Veronica Sandoval, Licensee. The purpose of the inspection was explained. LPA’s were granted access to the home by the Licensee and the Licensee received the Entrance Checklist (LIC 126).

The facility operates Monday to Saturday from 6:00 a.m. to 6:00 p.m. LPA's observed required postings, including the Facility License, Notification of Parent's Rights (PUB 393), Emergency Disaster Plan (LIC610A), and Earthquake Preparedness Checklist (LIC 9148) were visible near the front entrance to the daycare. The last fire/disaster drill was completed on 12/1/2024. The Licensee was reminded that fire and disaster drills must be conducted and documented every six months.

LPA's observed four children; 2 preschoolers and 2 school-age in the home during today's inspection. The licensee was operating within capacity and ratio requirements. Supervision policies were reviewed with the licensee, who acknowledged that she must be present during daycare hours and ensure children are always supervised. She was reminded that children must not remain in parked vehicles and that car seats are for transportation purposes only, not for sleeping. Mandated reporting requirements for suspected child abuse, and incident reporting were reviewed. Off limit areas in the home: 3 bedrooms, 1 bathroom, kitchen, and garage. Off limit areas outside the home: front yard and right side yard

The Licensee confirmed that the only adults residing in the home are herself, her husband, her two sons, her daughter and her daughter's boyfriend (P1). Daughter's boyfriend (P1) does not have fingerprint clearances.

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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: SANDOVAL, VERONICA
FACILITY NUMBER: 444406156
VISIT DATE: 01/08/2025
NARRATIVE
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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.

LPA’s toured the indoor and outdoor areas of the home during today’s inspection. LPA's observed that the 3A-40B-C fire extinguisher was last serviced on 12/2022, working smoke and carbon monoxide detectors, and a working telephone 831-587-9289. The home was clean, well-ventilated, and stocked with toys and playthings that are safe and age-appropriate for the children. All poisons were locked. All hazardous items were securely stored out of reach. No bodies of water were observed. Licensee was reminded that smoking is not allowed, and baby walkers, bouncers, jumpers, or similar items cannot be used for children in care and must be kept inaccessible. The fireplace has a barricade. The Licensee confirmed that no firearms or ammunition were present. The Licensee was reminded to notify the Department before making any alterations or additions to the home or grounds

Licensee has current CPR and First Aid certifications (expiration: 5/9/2025). Licensee has the required vaccines (MMR, Pertussis, & flu) and is not current with her Mandated Reporter Training for Child Care Workers (expiration: 6/9/2024). LPA's reviewed six children's files and the files were complete with the required forms. LPA's reviewed Licensee's two assistants file and both Mandated Reporter Training are expired. The Licensee was reminded to renew certifications every two years. Licensees stated that a child will be isolated from the other children in the room by the children's bathroom if necessary due to illness or communicable disease until a parent/guardian is able to pick them up.

LPA discussed the safe sleep regulations with licensee, Veronica Sandoval, and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.



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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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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: SANDOVAL, VERONICA
FACILITY NUMBER: 444406156
VISIT DATE: 01/08/2025
NARRATIVE
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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/

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Licensee was reminded Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program
Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Child Care option to receive email communication.

During the exit interview, the Licensee confirmed no Registered Sex Offenders reside at the facility. The LPA completed the RSO profile in FAS on December 26, 2024. A search of the California Attorney General-Megan’s Law website found no registered sex offenders at the facility address.

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.

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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
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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: SANDOVAL, VERONICA
FACILITY NUMBER: 444406156
VISIT DATE: 01/08/2025
NARRATIVE
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During today’s inspection, Type A and Type B deficiencies are issued on attached 809-D. Appeal rights provided.

LPA's informed licensee, Veronica Sandoval, that this report dated January 8, 2025 documents one (1) Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. LPA's informed the licensee to provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Exit interview conducted and report was reviewed with the Licensee, Veronica Sandoval.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/10/2025 10:29 AM - It Cannot Be Edited


Created By: Darnella Barnes On 01/08/2025 at 12:21 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SANDOVAL, VERONICA
FACILITY NUMBER: 444406156

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/08/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and licensee statement, P1 is residing in the home without fingerprint clearances which poses an immediate health, safety or personal rights risk to persons in care. Civil penalty of $500.00 was assessed.
POC Due Date: 01/09/2025
Plan of Correction
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By POC due date: 01/09/25, licensee to submit a written plan to ensure that all adults residing or working in the home shall have fingerprint clearances prior to initial presence in the home.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Susy Cervantes
LICENSING EVALUATOR NAME:Darnella Barnes
LICENSING EVALUATOR SIGNATURE:
DATE: 01/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2025


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Document Has Been Signed on 01/10/2025 10:29 AM - It Cannot Be Edited


Created By: Darnella Barnes On 01/08/2025 at 12:21 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SANDOVAL, VERONICA
FACILITY NUMBER: 444406156

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/08/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observation, the fire extinguisher was last serviced on 12/2022 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/17/2025
Plan of Correction
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Licensee states that Fire Marshall will service the existing fire extinguisher at the entrance of the day care and will submit proof that fire extinguisher has been service reflecting the current date by 01/17/25.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's record review, the licensee did not comply with the section cited above in three out of three persons, Licensee and two Assistants which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/29/2025
Plan of Correction
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Licensee will provide proof of documentation of current Mandated Reporter Training for Child Care Providers by/29/25
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Susy Cervantes
LICENSING EVALUATOR NAME:Darnella Barnes
LICENSING EVALUATOR SIGNATURE:
DATE: 01/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2025


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