<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444416070
Report Date: 09/15/2022
Date Signed: 09/21/2022 10:35:26 AM

Document Has Been Signed on 09/21/2022 10:35 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ABUNDES, PATRICIAFACILITY NUMBER:
444416070
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
09/15/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Patricia AbundesTIME COMPLETED:
01:00 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) Elizabeth Berumen met with Applicant, Patricia Abundes to conduct an announced pre licensing inspection at 115 Grant Ave. Watsonville, CA. LPA was granted access to the home by Applicant. The Applicant and her three minor children live in the home.

Days and hours of operation will be Monday - Friday from 6:00 AM to 6:00 PM. Applicant completed her Preventative Health and Safety Child Care Training on February 2, 2021 and copies of the certifications are on file and include lead and nutrition components. Applicant's CPR and First Aid certifications are current and expire on March 29, 2023. Applicant completed the Mandated Reporter Training for Child Care Workers on June 6, 2022 and a copy of the certification is on file. A copy of current TB test, flu, Mmr, and Tdap vaccinations are on file. Licensee owns the home and a copy of 2021 annual tax and interest statement was provided during today's inspection verifying control of property.

Applicant does not have liability insurance at this time and will issue Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282) until they obtain liability insurance.

LPA inspected the indoor and outdoor areas of the home with the Applicant during today's inspection. There are no stairs or wall heater units inside the home. Off limit areas in the home: three bedrooms. Off limit areas outside the home: storage shed, laundry room and garage. All three off limit areas outside are locked.

The home is clean, orderly, and ventilation for safety & comfort. LPA observed a fenced backyard, and no bodies of water. Applicant states that there are no weapons in the home.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: ABUNDES, PATRICIA
FACILITY NUMBER: 444416070
VISIT DATE: 09/15/2022
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
26
27
28
29
30
31
32
LPA provided and reviewed the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

LPA provided and discussed the safe sleep regulations with Applicants 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 Applicants 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.

APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS:
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: http://www.ada.gov/childqanda.htm

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 platform.

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.

Exit interview conducted and report was reviewed with the Applicant, Patricia Abundes. LPA advised Patricia that before a small license (capacity 8) can be approved the following must be met:
1. A 2A10BC fire extinguisher (send LPA proof of purchase and picture).
2. Update LIC279 to reflect correct address: 115 Grant Ave. (provided during inspection).
3. LPA did not observe sufficient toys, supplies, and equipment for the day care children both indoors/outdoors. Applicant stated she has a few items and showed LPA during inspection. LPA asked for pictures of the set up once it is done.
4. Applicant states she is going to remove the entertainment and TV set up from living room and move it to the garage. LPA notes that the entertainment stand has an electric fire place.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: ABUNDES, PATRICIA
FACILITY NUMBER: 444416070
VISIT DATE: 09/15/2022
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
26
27
28
29
30
31
32
Applicant states that she does not have any pets in the home. Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. Some items are stored in locked laundry shed outside the home. Applicants states that there are no poisons in the home and understands that poisons are to be locked. LPA reminded Applicant that smoking, baby walkers, and similar items are not allowed in Family Child Care Homes.

Applicants states that she is not sure if she will administer medication to children at this time. She understands if she does administer medication in the future an incidental medical service plan is required. Applicant states that a sick child will be isolated in the living room area or dining room area if necessary due to illness or communicable disease. Applicant has a First Aid kit and stored inaccessible to children.

Applicant states that she will talk to children and use re-direction as form of discipline. Applicant understand that children's personal rights can not be violated; including no corporal punishment.

Isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed. LPA informed Applicant that fire/disaster drills must be practiced at least once every 6 months and documented. LPA informed Applicant the requirement to keep an update facility roster. A copy of the roster was provided today.

Applicant, Patricia Abundes was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 requirements of AB 633 with the Applicants. The Applicants understand the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations with the Applicants and advised them of the assessment of an immediate $500 civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3