Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274413414
Report Date: 12/12/2018
Date Signed: 12/12/2018 10:41:00 AM

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: 3DATE:
12/12/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Maria RochaTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Joe Macias conducted an unannounced Annual Random Inspection. The purpose of today’s visit is to ensure the home is in compliance with Title 22 California Code of Regulations. LPA was greeted and granted entrance by the Licensee Maria Rocha. Todays census is 4 (1 infant, 3 preschool age). The centers hours of operation are Monday - Friday, 6am - 6pm. The Licensee, her husband Hugo Valencia, and adult daughter Iris Rocha are cleared and the only adults who resides in the home. The Licensee's CPR and First Aid are current, and expire March 5, 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 11/16/2018. LPA reviewed four children's files, and observed all required documents. 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 orderly, and safe for the day care children. LPA observed a barricaded wall heater in the home. Off limit areas of the home: all bedrooms, and garage.

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 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 medications at this time.

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 staff immunization records on file.

LPA also went over safe sleep for infants.

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

DATE: 12/12/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2018
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: ROCHA, MARIA
FACILITY NUMBER: 274413414
VISIT DATE: 12/12/2018
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A review of staff records on December 12, 2018 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. A $500 immediate civil penalty. An ongoing $100 per day per violation continues until the violation(s) is corrected. LPA discussed the requirements of AB633 to licensee and provided her the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and licensee understands the requirements.

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 present. LPA provided the Licensee with the ratio/capacity chart for her reference. The Licensee states that she does not transport children; however understands that children cannot be left in parked vehicles unattended any time.

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 (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

The Licensee has completed the Mandated Reporter Training.

Department website: www.ccld.ca.gov provided to Licensee.

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: 12/12/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2018
LIC809 (FAS) - (06/04)
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