444415698-12-6-2024-07-CC-EWOS-DBPSP9-20241206130247

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444415698
Report Date: 12/06/2024
Date Signed: 12/06/2024 01:02:56 PM

Document Has Been Signed on 12/06/2024 01:02 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:	GEORGE, ASHLEY		FACILITY NUMBER:	444415698
ADMINISTRATOR/ DIRECTOR:	GEORGE, ASHLEY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 896-5570
CITY:	SANTA CRUZ	STATE: CA	ZIP CODE:	95062
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 12	DATE:	12/06/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:15 AM
MET WITH:	Ashley George		TIME VISIT/ INSPECTION COMPLETED:	01:15 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	On December 6 2024, at 10:15 AM, Licensing Program Analyst (LPA) Elimika Woods met with licensee Ashley George for an Unannounced 3 Year Required Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during the inspection were the licensee's two fingerprint cleared assistants. There were 12 children present during today’s inspection, 11 pre-school age children and one infant. The licensee stated that the facility operates from Monday to Friday 8:00 AM to 4:30 PM. LPA toured the facility inside and out to conduct a Health and Safety inspection. This address has two single family homes which consists of four bedrooms, four baths, two living and dining rooms, two kitchens, two backyards and detached two car garage. This home was clean and orderly, with (centralized) heating and ventilation for the safety and comfort. The off-limits will be made inaccessible by closed and/or locked doors and visual supervision. There's a gate at the bottom of the stairs to prevent children five years or younger access to the upper floor in home number two and the garage area. LPA checked the cabinets in the on limit areas which includes the kitchen in home one, the bathrooms, the bedrooms, and any other cabinets or drawers accessible to children in care and did not observe any hazardous materials or toxins accessible to children during today’s inspection. At 11:00 AM, LPA inspected the backyard area to make sure that there are no pools, hot tubs or any other bodies of water present that violates the childcare licensing laws and there were none, during today's inspection. On- Limit areas are the: All bedrooms, downstairs bathrooms in both houses, kitchen in house #2, both living rooms Off- Limit areas are the: Entire second level of house #1, kitchen in house #1, patio deck above the garage and garage. LPA tested the smoke detector in the bedroom and the carbon monoxide detector in the kitchen and found them to be functioning properly. The facility has two fully charged 3A40BC fire extinguisher which meets standards established by the State Fire Marshal in both homes. The licensee also has a first aid kit that she keeps in the kitchen cabinet in home number one. The Isolation area of the home will be the first bedroom in home number one, away from other children in care. See 809-C for continuance.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

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: GEORGE, ASHLEY	FACILITY NUMBER: 444415698
	VISIT DATE: 12/06/2024

NARRATIVE

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This home has a fireplace that has a barricade/screen to prevent access by children in the living room of home number (two). LPA Woods asked the licensee does she transports children and the licensee stated that she does not transport children. During the record review LPA Woods checked the Health Records of the licensee, staff, and children and found that the licensee is following the immunization laws which pertain to all childcare providers.

The Backyard area is the fully fenced backyard and LPA observed that it is free from defects or dangerous conditions. During today's inspection, there are no play structures which are required to be anchored. The backyard area has a large oval climbing structure with cushioning underneath to absorb children falls. There are ample age-appropriate toys that appear to be safe and in good condition. There's a converted shed that's used as a play house for children near home number one and a patio deck above the garage near home number one that's off-limits to children in care. There's a gate at the bottom of the stairs of the garage preventing children access to the upper level.

At 10:30 AM, LPA requested and reviewed the files of four (4) children in care and two staff files. All children’s files contain Identification & Emergency Information, Parent's Rights, and Medical Consent forms and the staff file has the required Employee Rights and Health Screening forms. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 09/06/2024. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires on 03/2025. The licensee and staff has not completed mandated reporter training. Per licensee there are no weapons of any kind in the home. The licensee is in ratio today. All required forms are posted and visible for public review.

The following deficiencies were observed during today's inspection:
At 11:30 AM, LPA observed during the file review that the licensee and staff did not have their current Mandated Reporter training certificates.

Effective August 1, 2003, California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

See 809-C for continuance.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

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: GEORGE, ASHLEY	FACILITY NUMBER: 444415698
	VISIT DATE: 12/06/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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/

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

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.

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.

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

During the exit interview, the LICENSEE Ashley George, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

See 809-D for deficiencies cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Ashley George.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/06/2024 01:02 PM - It Cannot Be Edited

Created By: Elimika Woods On 12/06/2024 at 12:30 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: GEORGE, ASHLEY	FACILITY NUMBER: 444415698
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in which the licensee and staff did not complete their mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/20/2024
	Plan of Correction
1 2 3 4	Licensee and staff will complete Mandated Reporter training and send LPA the certificates by 12/20/2024 by fax, email, or text message.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Chandra Charles

LICENSING EVALUATOR NAME:

Elimika Woods

LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

LIC809 (FAS) - (06/04)

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