444416809-4-3-2023-07-CC-CNEN-CQJQJ6-20230403121212

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444416809
Report Date: 04/03/2023
Date Signed: 04/03/2023 12:12:21 PM

Document Has Been Signed on 04/03/2023 12:12 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	MORALES RODRIGUEZ, JESUS		FACILITY NUMBER:	444416809
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	04/03/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:29 AM
MET WITH:	Jesus Morales Rodriguez		TIME COMPLETED:	12:30 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 Analysts (LPA's), Cortney Nelson and Farida Raja, met with Applicant, Jesus Morales Rodriguez, for announced pre-licensing inspection. The purpose of today's inspection is to ensure home is in compliance with Title 22 California Code of Regulations. Upon arrival, LPA's were admitted into the home by Applicant and toured inside and outside of the family child care home (FCCH). Applicant states that adults over the age of 18 living in the home are himself and his girlfriend (Jessica Vasquez). Applicant additionally has two minor children living in the home. The hours of operation for the FCCH will be Monday-Friday, 6:00AM-6:00PM and the Applicant is planning to offer care for children ages 3 months - 13 years. The Applicant has submitted proof of ownership for the home and maintains current liability insurance. LPAs advised providing Affidavit Regarding Liability Insurance (LIC282) to parents if he does not maintain insurance in the future. The Applicant 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. LPA's toured inside the home and observed sufficient materials and equipment for day care children. Off limits inside the home include: master bedroom, master bathroom, one bedroom, kitchen, and laundry room. There is a working telephone (cell phone) at the FCCH. The Applicant does not currently have any cots or mats and states that he will be purchasing them. The Applicant additionally states that he is planning to obtain a crib from Migrant Head Start once he receives his license. LPAs discussed Infant Safe Sleep with the Applicant and reviewed required documents, such as nap checks and Individual Infant Sleep Plan (LIC9227) for infants under 12 months of age. The Applicant states that he is planning to administer medication and provide Incidental Medical Services (IMS) to children as needed. Food will be prepared and provided by the FCCH, Applicant states that he is planning to work with Community Bridges and will be providing breakfast, lunch, PM snack, and dinner. LPA's observed cleaning compounds and kitchen knives properly stored inaccessible to children. The Applicant states there are no weapons or firearms in the home.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

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: MORALES RODRIGUEZ, JESUS	FACILITY NUMBER: 444416809
	VISIT DATE: 04/03/2023

NARRATIVE

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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 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.

There is a bathroom in the home that is clean, operable, and sanitary for children's use. The Applicant has a foam baby diaper changing mat for use when infants are in care. The bathroom has a bedroom door attached to it which the Applicant states will remain locked during the hours the day care is open. There are no pets in the home. The Applicant states that he will wash napping materials for the children 1-2 times per week. The home has central air.

LPA's toured outside the home and observed the space for children in fenced in and contains age-appropriate toys for the children. LPA's advised that toys for children's play are cleaned as they were observed to be dirty. The Applicant states that he is planning to install additional materials for the children, such as a sandbox, and purchase additional toys too. The ground for children's playing was observed to be covered with turf. Off-limits outside the home include: driveway and backyard beyond fenced area for children. No outdoor bodies of water were observed during todays inspection.

LPA's observed a fully charged 3A40BC fire extinguisher, working smoke detector and carbon monoxide detector. LPA's advised completing annual maintenance for fire extinguisher. The Applicant was provided a fire/emergency disaster drill log and was advised it should be completed every 6 months.

The Applicant states that for discipline of the children, he will conduct a "behavior check" and talk with the children. During that time, the child will likely have a time-out and LPA's advised that recommended duration for "time out" as 1 minute per year of age for the child. The Applicant understands that children's personal rights should not be violated; including no corporal punishment. Children should not be left for extended periods of time in furniture such as a high chair or play pen.

LPA's discussed isolation of a sick child with the Applicant and he states that if a child were to start feeling sick at his home that he would isolate the child in the dining room until parents are able to pick the child up. The Applicant states that he is planning to conduct a wellness check upon arrival for the children.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

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: MORALES RODRIGUEZ, JESUS	FACILITY NUMBER: 444416809
	VISIT DATE: 04/03/2023

NARRATIVE

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LPA's additionally discussed supervision of children, unusual incidents (LIC624B), and requirements for additional staff/ adults living in the home. The Applicant states that he is planning to transport children in his girlfriends Honda Pilot. LPAs advised that the vehicle will need to be inspected and proof of current car insurance and vehicle registration needs to be provided. The Applicant understands that he must be home at least 80% of the time FCCH is open.

LPA's reviewed small family child care home capacity requirements with the Applicant and provided copy of 102416.5 Staffing Ratio and Capacity from California Code of Regulations. LPA's advised the Applicant that infants are children under 2 years of age. The Applicant understands the requirements of one (1) child in kindergarten or elementary school and at least one (1) child age six (6) for capacity of eight (8) and that there should never be more than four (4) infants present at the FCCH. LPA's advised the Applicant that his girlfriend's minor son will be included in his capacity/ratio until he turns ten (10) years of age.

LPA's discussed required postings with Applicant and provided copies of Parents Rights bulletin (PUB394) and Earthquake Preparedness Checklist (LIC9148). LPA reviewed and provided documents to Applicant for children's files, personnel files, and facility records (LIC311D). LPA's discussed Provider Information Notices (PINs). LPA's additionally reviewed CCLD website, Santa Cruz County Resource & Referral, and online annual fee payment.

LPA's discussed the safe sleep regulations with the Applicant and provided 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.

Exit interview conducted and report was reviewed with the Applicant, Jesus Morales Rodriguez.

LPA's advised applicant that a small family day care license will be issued pending manager review and completion of the following corrections:
-Proof of purchase for mats/cots for children's napping
-Review of vehicle for transporting children (submit proof of vehicle registration, car insurance, drivers license of those who will transport children, and vehicle properly set up with booster sets/ car seats)
-Outside toys need to be cleaned, pictures can be provided of cleaned materials

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

LIC809 (FAS) - (06/04)

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