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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274400458
Report Date: 05/14/2025
Date Signed: 05/14/2025 03:49:49 PM

Document Has Been Signed on 05/14/2025 03:49 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:CARMELO INFANT/TODDLER PROGRAM OF CCDCFACILITY NUMBER:
274400458
ADMINISTRATOR/
DIRECTOR:		LAURA DUNNFACILITY TYPE:
830
ADDRESS:8460 CARMEL VALLEY ROADTELEPHONE:
(831) 624-8047
CITY:CARMELSTATE: CAZIP CODE:
93923
CAPACITY: 8TOTAL ENROLLED CHILDREN: 9CENSUS: 6DATE:
05/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Laura DunnTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On May 14, 2025 at 9:45 AM, Licensing Program Analysts (LPAs), Marilou Monico and Kate Huang, met with Program Director, Laura Dunn, for an unannounced Annual Random Inspection. LPAs provided Site Director the Entrance Checklist (LIC 125). The infant program operates Monday thru Friday from 7:15 AM to 4:30 PM. The infant program serves children ages 0-24 months in the Infant/Toddler Room.

LPAs toured the indoor and outdoor areas of the facility. The facility is within ratio & capacity compliance today. The classroom has age-appropriate materials, toys, furnishing, equipment, & adequate storage for children’s belongings. The children's napping equipment were observed to be stored in a healthful manner. Bedding is provided by the facility and is washed daily. LPAs observed functioning smoke and carbon monoxide detectors. The room has fully charged fire extinguisher. The isolation area for sick children is the Nurse's Office.

The center provides snacks and lunch to children. All center provided food items are properly labeled & stored separately from cleaning supplies. Children have the option to bring their lunch from home or have food from the district high school's cafeteria located at 3600 Ocean Avenue, Carmel-By-The-Sea, CA 92923. There is a kitchen at the facility for snacks preparation. The kitchen is equipped with refrigerator, microwave, and a sink with hot and cold running water. Snacks and lunch menus are posted at least one week in advance, available for review, & dated. Solid waste bins are equipped with tight fitting lids. Drinking water is available for the children in the classroom via bottles and sippy cups. There is a diaper changing table within arm's sink of a sink.

The outdoor play area is fully fenced. Shade is provided by canopies and building overhang. All equipment and surfaces are free from hazards. There are no bodies of water on the premises. There are age-appropriate outdoor toys and materials for the children. LPAs observed portable climbing structures with inadequate resilient material under and around the structures. Drinking water is provided in bottles and sippy cups. Per Program Director, there are no firearms or weapons on the premises.

Continuation on next pages:

NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Marilou Monico
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: CARMELO INFANT/TODDLER PROGRAM OF CCDC
FACILITY NUMBER: 274400458
VISIT DATE: 05/14/2025
NARRATIVE
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 LPAs reviewed the facility roster. At least one staff member has a current Pediatric CPR/First-Aid Certification. LPAs observed all required postings in a publicly accessible area. LPAs reviewed the sign in/out sheet. Fire/disaster drill was conducted on April 27, 2025.

LPAs reviewed six (6) random children files during today's inspection for the following records: Admission Agreement, Personal Rights (613A), Identification and Emergency Information (LIC700), Notification of Parents Rights (LIC995A), Consent for Emergency Medical Treatment (LIC627), Physician’s Report (LIC 701), TB Test, Individual Infant Sleeping Plan (LIC 9227), sleep log, and Immunization records. LPAs observed that the Infant Needs and Services Plan for five children (C2 thru C6) are not updated quarterly.



LPAs reviewed two (2) staff (S1-S2) files for the following records: Health Screening Report (LIC 503), Statement Acknowledging Requirement to Report Child Abuse (LIC 9108), Employee rights (LIC 9052), staff qualifications, immunization records, and required training. Program Director was reminded of their responsibility to renew CPR/First Aid and Mandated Reporter Training every two years.

LPA discussed the safe sleep regulations with the Program Director Laura Dunn and discussed 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. LPA also informed Program Director 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.



Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Marilou Monico
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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: CARMELO INFANT/TODDLER PROGRAM OF CCDC
FACILITY NUMBER: 274400458
VISIT DATE: 05/14/2025
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Fingerprint clearances for individuals at this facility who require caregiver background checks are issued by State Department and/or County Office of Education and do not come under the jurisdiction of Community Care Licensing Division.



Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).



LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Program Director, Laura Dunn, 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.

LPAs reminded Program Director to report unusual incidents or injuries to children in care to the Department of Social Services using the Unusual Incident/Injury Report form (LIC 624). Incidents must be reported within 24 hours to the regional office by phone and the written report, LIC 624, within 7 calendar days.

As a result of this inspection, Type B deficiencies are cited on the following page.

A Notice of Site Visit was given and must remain posted for 30 days.



Exit interview conducted and report was reviewed with Program Director, Laura Dunn.
NAME OF LICENSING PROGRAM MANAGER: Gladys Kuizon
NAME OF LICENSING PROGRAM ANALYST: Marilou Monico
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/14/2025 03:49 PM - It Cannot Be Edited


Created By: Marilou Monico On 05/14/2025 at 02:56 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: CARMELO INFANT/TODDLER PROGRAM OF CCDC
FACILITY NUMBER: 274400458

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(e)
Outdoor Activity Space
(e) As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation, the licensee did not comply with the section cited above. LPAs observed that the portable climbing structures in the infant playground do not have adequate cushioning under and around the structures which pose/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/16/2025
Plan of Correction
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Program Director removed the climbing structures immediately during the inspection. Deficiency corrected.
Type B
Section Cited
CCR
101419.3(a)
Modifications to Infant Needs and Services Plan
(a) The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on records review, the licensee did not comply with the section cited above. Five children (C1-C5) are missing updated Infant Needs and Services Plan which pose a potential risk to the health, safety, and personal rights risk to persons in care.
POC Due Date: 05/23/2025
Plan of Correction
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Program Director states that she will submit updated Infant Needs and Services Plan for the five children by 05/23/25.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Gladys Kuizon
NAME OF LICENSING PROGRAM MANAGER:
Marilou Monico
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2025


LIC809 (FAS) - (06/04)
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