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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444418197
Report Date: 02/20/2025
Date Signed: 02/20/2025 04:34:18 PM

Document Has Been Signed on 02/20/2025 04:34 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:ORTIZ ALVAREZ, LETICIAFACILITY NUMBER:
444418197
ADMINISTRATOR/
DIRECTOR:
LETICIA ORTIZ ALVAREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 789-5127
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/20/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Leticia Oritz AlvarezTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On 02/20/25, at 1:50 P.M., Licensing Program Analyst (LPA) Teodoro Trujillo met with Applicant, LETICIA ORTIZ ALVAREZ, to conduct an announced change of location inspection. LPA was granted access to the home by the Applicant. Applicant Leticia and her 18-year-old son were present today, 26-year-old adult son arrived during site visit. The Applicant, her spouse, 26 -year-old and 18 year old son are the only adult residing in the home.

Days and hours of operation will be Monday – Friday from 06:00 AM to 6:00 PM. Applicants CPR and First Aid certifications are current and expire on 01/23/2026. Copies of both certifications are on file. LPA observed applicant completed the Mandated Reporter Training for Childcare Workers on 04/07/24 and 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 verifying control of property is on file. Applicant understands that she cannot care of more than eight (8) children at any time. Applicant states she has liability insurance and will issue Affidavit Regarding Liability Insurance for Family Child Care Home (LIC282) in the future if there is no coverage.

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. LPA observed no fireplace in the home. Applicant states that she will operate the day care in the following areas: Living room, hallway bathroom, dining room 1 and rear yard play area. Off limit areas inside the home: bedroom 1, bedroom 2, master bedroom with master bathroom and attached garage. Off limit outside: gated left and right side yard area.

The home is clean, orderly, (including heating/air conditioning), and ventilation for safety & comfort. Applicant does have sufficient toys, supplies, and equipment for the day care children for both indoors and outdoors. LPA observed a fully charged fire extinguisher (3A40BC) and working carbon monoxide and smoke detectors. Applicant states that she does not have weapons/ammunition in the home. Applicant states there are two small, vaccinated dogs in the home.

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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE: DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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: ORTIZ ALVAREZ, LETICIA
FACILITY NUMBER: 444418197
VISIT DATE: 02/20/2025
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Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. 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 the living 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 02/20/25 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 LETICIA ORTIZ ALVAREZ 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 applicant LETICIA ORTIZ ALVAREZ 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 LETICIA ORTIZ ALVAREZ 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.

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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
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: ORTIZ ALVAREZ, LETICIA
FACILITY NUMBER: 444418197
VISIT DATE: 02/20/2025
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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. LPA provided the applicant the Department website: www.ccld.ca.gov

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

LPA advised if there is unusual incident to report to call Licensing within 24 hours and to follow up with an LIC624B within 7 days. In addition, for general questions, questions regarding licensing requirements call Child Care Licensing.

LPA advised the applicant that prior to making alterations or additions to the home or grounds, the Licensee shall notify the Department of the proposed change.

Exit interview conducted and report was reviewed with the Applicant, LETICIA ORTIZ ALVAREZ, and LPA advised her that a Small Family Childcare Home License is approved, pending Licensing Program Manager approval.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC809 (FAS) - (06/04)
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