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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444417751
Report Date: 02/09/2024
Date Signed: 02/09/2024 12:00:10 PM

Document Has Been Signed on 02/09/2024 12:00 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:ROCHA, MARIAFACILITY NUMBER:
444417751
ADMINISTRATOR:ROCHA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 786-6398
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/09/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Maria RochaTIME COMPLETED:
12:15 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
Licensing Program Analysts (LPA) Teodoro Trujillo met with Applicant, Maria Rocha, to conduct an announced pre-licensing inspection. LPA was granted access to the home by the Applicant. No children were present in the home during today's inspection. The Applicant, her spouse Luis Rocha and adult son, Luis Rocha, Jr. are the only adults living in the home. There are no minor children residing 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 10/21/2020 and lead component on 12/09/17 and a copy of the certification is on file. Applicants CPR and First Aid certifications are current and expire on 03/20/2024. Copies of both certifications are on file. Applicant completed the Mandated Reporter Training for Child Care Workers on 08/12/23, and a copy of the certification is on file. A copy of current TB test, flu, Mmr, and Tdap vaccinations for the Applicant are on file. Applicant owns the home and a copy of the property tax statement verifying control of property is on file. Approved fire clearance was received on 01/22/2024. Applicant understands that she cannot care for more than 14 children at any time. Applicant does not have liability insurance and will issue Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282).

LPA toured the indoor and outdoor areas of the home with the Applicant during today's inspection. The Applicant's home is a single-story home with back yard on a sloped hillside. LPA observed barricaded stairs in the outside deck leading to bottom back yard area during today's inspection. LPA observed no wall heaters. LPA observed no fireplace in the home. Applicant states that she will operate the day care in the following areas: Living room, daycare room, hallway bathroom, and kitchen. On limit outside: rear back yard top deck area next to kitchen floor level, the gate leading down to bottom off limit yard area needs to be closed. Off limit areas inside the home: bedroom 1, bedroom 2, bedroom 3 with master bathroom and attached garage. Off limit outside: left and right side yard area, bottom yard area, 2nd level deck area and cement drain canal that is covered by thin chicken wire that does not support the weight of an adult or preschool age child.

The home is clean, orderly, (including heating/air conditioning), and ventilation for safety & comfort. There is sufficient toys, supplies, and equipment for the day care children both indoors/outdoors. LPA observed a fully charged fire extinguisher (2A10BC) and working smoke and carbon monoxide detectors, fenced backyard, and no bodies of water. Applicant states that she does not have any weapons/ammunition in the home.

continued on next LIC809, Page 1 of 3
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ROCHA, MARIA
FACILITY NUMBER: 444417751
VISIT DATE: 02/09/2024
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
Continued from previous 809, Page 2 of 3

Applicant states there is one vaccinated small dog in the home. Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. Applicant states that poisons and cleaning products and detergents are stored in the locked garage. LPA reminded Applicant that smoking, baby walkers, and similar items are not allowed in Family Child Care Homes. Applicant states that she will not administer any medication to the children at this time. Applicant states that a child will be isolated in a couch in the living room area if necessary due to illness or communicable disease. Applicant has a First Aid kit in the home.

Applicant understands that children's personal rights should 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.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 02/07/2024 was reviewed and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. Applicant spouse has an exemption on file. Applicant Maria Rocha 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 discussed the requirements of AB 633 with the Applicant. The Applicant understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations with the Applicant and advised her 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.

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 also discussed the importance of maintaining records for any person/assistant providing care to the children and children in the home under 10 years of age.

LPA discussed the safe sleep regulations with licensee Maria Rocha 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 applicant Maria Rocha 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.

Continued on next 809, Page 2 of 3
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: ROCHA, MARIA
FACILITY NUMBER: 444417751
VISIT DATE: 02/09/2024
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
Continued from previous 809, Page 3 of 3

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

PIN 22-02-CCP - Best Practices Related to the Provision of Incidental Medical Services in Child Care Center and Family Care Homes was provided to Applicant.

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. LPA provided the applicant the Department website: www.ccld.ca.gov

Licensee Maria Rocha 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.

Exit interview conducted and report was reviewed with the Applicant, Maria Rocha, and LPA advised her that a Large Family Child Care Home License is pending approval by Licensing Program Manager and barricading the back yard drain canal.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3