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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274407693
Report Date: 07/26/2023
Date Signed: 08/01/2023 12:09:52 PM

Document Has Been Signed on 08/01/2023 12:09 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ORTIZ, ESPERANZAFACILITY NUMBER:
274407693
ADMINISTRATOR:ORTIZ, ESPERANZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 763-2650
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
07/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Esperanza OrtizTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA), Elizabeth Berumen, conducted an annual random inspection. LPA met with Licensee, Esperanza Ortiz. Present during the visit were 10 day care children; all preschool age and Licensee's Assistant (Mariana Fernandez Ortiz).

Day care hours are Monday - Friday from 6:00 AM to 6:00 PM. Licensee has current CPR and First Aid certification with an expiration date of 01/23/2025. Mariana Fernandez Ortiz has current CPR & First Aid 01/23/25. Mandated Reporter Training expires 05/18/2024. Mariana Fernandez Mandated Reporter Training expires 01/19/25.

There are 5 adults living in the home; Licensee, her husband, two adult daughters and sister in law. A review of staff records on July 26, 2023 indicates that all 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.

LPA reviewed completed Child Care Facility Roster during today's visit. LPA reviewed fire disaster drill log; last practiced drill was 07/03/23. LPA observed sufficient materials, toys, and play equipment for the day care children. LPA inspected the indoor and outdoor areas of the home during today's visit.

The home is clean, orderly, and safe for the day care children. LPA observed a barricaded wall heater in the living room. Off limit areas in the home: three bedrooms, and laundry room. Off limit areas outside the home: detached studio/garage, one locked storage shed and carport.

LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detector, and no bodies of water. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. Esperanza understands that all poisons are to be locked.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2023
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: ORTIZ, ESPERANZA
FACILITY NUMBER: 274407693
VISIT DATE: 07/26/2023
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LPA reviewed six (6) children’s files during today's inspection for the following records: Notification of Parents Rights (LIC995A), Consent for Emergency Medical Treatment (LIC627), Identification and Emergency Information (LIC700), and Immunization Records. Licensee carries day-care insurance.
LPA provided and discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also reminded Licensee 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 she registers all infant devices with the CPSC to be notified of any recalls on her purchased equipment.

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.

Licensee, Esperanza Ortiz 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&R's) throughout California.

As a result of this visit, there were no deficiencies cited according to Title 22, Division 12, Chapter 3 of the CCR.
Facility site visit notice document was issued and posted and must remain posted for 30 days.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023
LIC809 (FAS) - (06/04)
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