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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444416796
Report Date: 04/09/2024
Date Signed: 04/09/2024 11:49:52 AM

Document Has Been Signed on 04/09/2024 11:49 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:VARGAS, ARACELIFACILITY NUMBER:
444416796
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 9CENSUS: 5DATE:
04/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Araceli VargasTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analysts (LPAs), Cortney Nelson and Andrea Cortez, met with Licensee, Araceli Vargas, for an unannounced Required- 1 Year Inspection. LPAs were granted access to the home by the Licensee and toured both indoors and outdoors during the inspection. Upon arrival, there were six children (two infants/ four preschool-age), the Licensee, and her Assistant (S1) , which is compliant with the home license capacity and ratio requirements. LPA observed all required postings near the entrance to the home and hours of operation are Monday – Friday, 7:00AM-4:30PM.

The Licensee states that adults, over the age of 18, residing in the home are: herself and her son (Alexander). All adults residing in the home have Criminal Background Check Clearance and proof of negative tuberculosis (TB) test.

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 reviewed facility roster (LIC9040) and fire/disaster drill log during todays inspection. The last fire/disaster drill was conducted 4/2024, which is compliant with the six-month requirement for homes. LPA observed a fully charged 3A40BC (last serviced: 3/2024) fire extinguisher, functioning smoke detector and carbon monoxide detector. Licensee states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. The Licensee states that there are no weapons or firearms in the home.

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/.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2024
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: VARGAS, ARACELI
FACILITY NUMBER: 444416796
VISIT DATE: 04/09/2024
NARRATIVE
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Indoor areas of the home were inspected by the LPAs today and observed to be clean, orderly, and safe for the day care children. Off-limits inside the home include: two (2) bedrooms and one (1) bathroom. There are no open-faced heaters in the home. Licensee has a fireplace in the home that is barricaded, locked, and safe for the children. Licensee understands that she cannot use the fireplace during day care hours. LPAs observed sufficient age-appropriate materials, toys, and play equipment in the home. Drinking water is readily available for children via filtered water jug dispenser and plastic cups. The bathroom in the home is clean, sanitary, and operable. The Licensee has a working telephone (cellphone) in the home.

The backyard area of the home was inspected. LPA observed sufficient play-equipment and supplies for the children that are in good condition and age-appropriate including plastic structures, plastic cars, and other toys. Off-limit areas outside of home include: areas beyond the fence. No outdoor bodies of water were observed during todays inspection.

LPAs 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-and-resources/safe-sleep as an additional resource. LPAs 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.

Six (6) children’s files were reviewed during todays inspection and most required documents were present. LPAs reminded the Licensee that documented nap checks are required for infants until they turn two (2) years of age. Documented nap checks shall include name of the infant, time of check, initials of staff member checking on the infant, and the physical state of the child. Nap checks shall be maintained in the infant's file and will be reviewed during annual inspections. LPAs further advised maintaining nap check documentation in the child's file, even after the child has turned two (2) years old, do not discard the documentation.

The Licensee and her Assistant's files were reviewed and LPAs reviewed required personnel requirements. Both have current CPR/First-Aid that expires 6/2024 and Mandated Reporter Training that expires on 2/27/2026. LPAs reminded that both trainings must be renewed by all staff every 2 years.

The Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: VARGAS, ARACELI
FACILITY NUMBER: 444416796
VISIT DATE: 04/09/2024
NARRATIVE
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LPAs reviewed large family child care home (FCCH) capacity requirements with Araceli and provided a copy of 102416.5 Staffing Ratio and Capacity from California Code of Regulations. LPAs advised that there should never be more than four infants (children under two years of age) present at the FCCH. If no assistant is present, then the FCCH shall comply with the capacity requirements for a small FCCH. LPAs advised that an assistant shall be at least 14 years old and, if under the age of 18, shall never be left alone with day care children.

The Licensee states that she transports day care children and LPAs confirmed the Licensee has current vehicle registration, car insurance, and CA drivers license. The vehicle for transporting children was additionally visually checked and proper booster seats/car seats were reviewed. LPA reminded Licensee that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Exit interview conducted and report was reviewed with the Licensee, Araceli Vargas.

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

As a result of todays inspection, deficiencies were cited, see LIC809-D.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

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 advised that a license for a large family child care home will be issued pending manager review/approval and submission of the following corrections:
-Submit approved fire clearance (STD850) from Watsonville Fire Department
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/09/2024 11:49 AM - It Cannot Be Edited


Created By: Cortney Nelson On 04/09/2024 at 11:15 AM
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: VARGAS, ARACELI
FACILITY NUMBER: 444416796

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(7)
Operation of A Family Child Care Home
(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on ,interview and record review, the licensee did not comply with the section cited above for one out of six children present as one child did not have completed file paperwork, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/12/2024
Plan of Correction
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The Licensee shall submit full children's file for one child (C1) by end of day 4/12/2024. LPAs advised that file for children's shall be completed prior to enrollment at a family child care home.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above as two out of six children reviewed were not indicated on the LIC9040, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2024
Plan of Correction
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The Licensee shall review the facility roster (LIC9040) and confirm that all children currently enrolled are indicated on it. Updated roster shall be submitted to the Department bt 4/15/2024.
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:Joel Segura
LICENSING EVALUATOR NAME:Cortney Nelson
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 04/09/2024 11:49 AM - It Cannot Be Edited


Created By: Cortney Nelson On 04/09/2024 at 11:15 AM
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: VARGAS, ARACELI
FACILITY NUMBER: 444416796

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above for infants (children under 2 years old) did not have 15 minute nap log documented, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/12/2024
Plan of Correction
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The Licensee to immediately start documenting infant nap checks every 15 minutes including name of the infant, initials of the staff member checking on the infant, and the time of the check. Completed nap checks for enrolled infants shall be submitted to the Department by 4/12/2024.
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:Joel Segura
LICENSING EVALUATOR NAME:Cortney Nelson
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024


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