444412784-4-29-2024-07-CC-FCJO-D4SUAR-20240429152509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444412784
Report Date: 04/29/2024
Date Signed: 04/29/2024 03:25:15 PM

Document Has Been Signed on 04/29/2024 03:25 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:	NAREZ, IRMA		FACILITY NUMBER:	444412784
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 0	DATE:	04/29/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:47 PM
MET WITH:	Irma Narez		TIME VISIT/ INSPECTION COMPLETED:	03:35 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 Analyst (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection and increase of capacity to the home today. LPA met with Irma Narez, Licensee, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Friday from 6:00 AM to 6:00 PM. Licensee has submitted an application for increase of capacity on 9/26/2023 and her home has been granted a fire clearance by the Watsonville Office of the Fire Marshall on 4/02/24. Licensee stated that she is the only adult that reside in the home with her minor 17 years old daughter. LPA observed there were no children present during the inspection. Licensee's certification for CPR and First Aid are current and will expire on 1/27/2026. LPA toured the indoor and outdoor areas of the home during today's inspection. LPA took a picture of the Child Care Facility Roster which is current. LPA reviewed the Fire/Disaster drill log during today's visit. Last fire drill was documented on 4/12/24. LPA reviewed five children's files and the files are complete. Licensee has a working telephone (landline) in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. LPA observed the home has a barricaded wall heater. Off limit areas in the home are the two bedrooms. The home has a washing and dryer area located next to the kitchen and it is on the way to the back yard. LPA observed there are no stairs inside the home. Licensee's home has a small back yard and it is fenced. LPA observed a fully charged 3A40BC fire extinguisher which was last serviced on 9/05/23. LPA observed there are not bodies of water in the home. LPA observed the home has at least one combo smoke and carbon monoxide detector. 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. ***********************************Report dated 4/29/24 continues in page 2.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: NAREZ, IRMA	FACILITY NUMBER: 444412784
	VISIT DATE: 04/29/2024

NARRATIVE

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Report dated 4/29/24 continues from page 1.

Licensee has in file immunization records for pertussis, measles, and flu vaccines for herself according with the SB792. LPA observed there is a dog pet in the home, licensee has proof of vaccination for the dog.
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 states that her grandchild Jessica transports children via vehicle and she understands that children cannot be left in parked vehicles unattended at any time.

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

Licensee has renewed the "Mandated Reporter" training on 1/13/23. Licensee understands that all the adults in contact with children are required to take the training, and renew it every two years.

Licensee was informed that if eventually a large license is granted, the maximum capacity is 14 and a qualified helper is required to be present whenever there are more than 8 children in care and ratio (age of the children) must be observed. Licensee understands that in absence of a qualified helper, her license capacity automatically returns to capacity 8 and ratio must be observed as well. Graphical material showing ratio for a small and a large FCCH licenses was provided to the licensee.

A review of staff records on 4/26/24 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 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.

Report dated 4/29/24 continues on page 3.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: NAREZ, IRMA	FACILITY NUMBER: 444412784
	VISIT DATE: 04/29/2024

NARRATIVE

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Report dated 4/29/24 continues from page 2.

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. 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

Exit interview conducted and report was reviewed with the licensee Irma Narez.

No deficiencies were cited today.

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

Licensee Irma Narez was informed that a large Family Child Care Home license would be approved pending on the following:

1) Approval from a manager of the Licensing Program.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

LIC809 (FAS) - (06/04)

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