Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274413414
Report Date: 07/12/2017
Date Signed: 07/12/2017 04:15:29 PM

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:ROCHA, MARIAFACILITY NUMBER:
274413414
ADMINISTRATOR:ROCHA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 272-3274
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY:14CENSUS: 6DATE:
07/12/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Maria RochaTIME COMPLETED:
04:35 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) Joseph Macias conducted an unannounced Annual Random visit. The purpose of today’s visit is to ensure the facility is in compliance with Title 22 California Code of Regulations. LPA was greeted and granted entrance by the Licensee Maria Rocha. Todays census is 6 (1 infant, 5 toddlers). The centers hours of operation are Monday - Friday, 6am - 6pm. The Licensee, her husband, eighteen year old daughter, and seventeen year old son are cleared and reside in the home. Licensee's CPR and First Aid are current and expire 03/05/2019.

LPA toured the indoor and outdoor areas of the home during today's visit. LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's visit. Last fire drill was conducted on 05/10/17. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the children in care. The home is clean, orderly, and safe for the day care children. LPA observed a securely gated wall heater in the home. Off limit areas in the home are as follows: all bedrooms, and the garage. LPA reminded Licensee that the children must be supervised at all times whenever they are outside in the back yard/ play area.

LPA observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, and no bodies of water. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, poisons, medications, and other similar items are out of reach and inaccessible to children. Licensee states that she does not administer any medications at this time. LPA discussed IMS and the new requirements with the Licensee. LPA advised the Licensee of the new immunization requirement (pertussis, measles, and flu vaccines) for all Licensees and staff that work directly with the children. LPA observed immunization records for the Licensee and all staff.

SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2017
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 2


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: ROCHA, MARIA
FACILITY NUMBER: 274413414
VISIT DATE: 07/12/2017
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
A review of staff records on July 10, 2017 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. LPA also reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours to ensure that the children are safe and supervised at all times. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time, with a qualified assistant. LPA provided the Licensee with the ratio/capacity chart for her reference. The Licensee states that she does not transport children; she understands that children cannot be left in parked vehicles unattended at any time.

A Family Child Care Home packet with updated Licensing forms was provided to the Licensee prior to the conclusion of today's visit. Department website: www.ccld.ca.gov provided to Licensee.

LPA also went over safe sleep for infants. www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

No deficiencies cited, exit interview conducted, and a copy of this report was provided to the Licensee.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE FRONT ENTRANCE TO THE HOME, AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Joseph MaciasTELEPHONE: (408) 334-8320
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2017
LIC809 (FAS) - (06/04)
Page: 2 of 2