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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274408357
Report Date: 05/20/2025
Date Signed: 05/21/2025 10:21:07 PM

Document Has Been Signed on 05/21/2025 10:21 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:MARTINEZ, MARIAFACILITY NUMBER:
274408357
ADMINISTRATOR/
DIRECTOR:		MARTINEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 728-3151
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
05/20/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Maria MartinezTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On May 20, 2025, Licensing Program Analyst (LPA) Darnella Barnes conducted an unannounced 3 year required inspection. The purpose was explained to the licensee, who granted access. and received the Entrance Checklist (LIC 126).

The facility operates Monday – Friday 6:00am to 6:00pm.. Required postings were visible, and the last fire/disaster drill for fire was on 5/13/25 and for earthquake 5/20/25. The licensee was reminded of the six-month drill and documentation requirement.

Licensee, two Assistants, 8 preschoolers and one infant were present, meeting capacity and ratio requirements. LPA observed that the licensee was providing care in a safe and comfortable environment, ensuring that children were treated appropriately and were free from any form of punishment or mistreatment. LPA noticed all children participating in circle time, singing morning songs, and doing manipulative tasks.

Licensee was provided information and reminded of capacity and ratio rules, supervision requirements, reporting obligations, and that children’s rights cannot be waived.

Licensee was also reminded that children showing signs of illness should be separated from others until it is determined whether they are contagious. They must remain separated until they are no longer infectious or are picked up.

All adults 18 and older associated with the facility, including residents and volunteers, have fingerprint clearances.

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NAME OF LICENSING PROGRAM MANAGER: Susy Cervantes
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2025
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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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: MARTINEZ, MARIA
FACILITY NUMBER: 274408357
VISIT DATE: 05/20/2025
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Licensee 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 Childcare 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 toured the facility’s indoor areas, the off-limit areas include garage, storage, 3 bedrooms, and one bathroom. The home was clean, well ventilated, and has safe toys, play equipment and materials. A fully charged 3A-40B-C fire extinguisher, was last serviced on 4/16/25, is available, along with working smoke and carbon monoxide detectors, and an operating telephone. All hazardous items, including poisons, detergents, cleaning compounds, and medicines were kept out of children’s reach. The home was free of defects or dangers that could harm a child. Licensee was reminded that smoking is prohibited. Additionally, Licensee confirmed that no firearms, guns, or ammunition are present on the premises

Outdoor off limit areas include storage area.. Licensee understands that outdoor play areas must either be fenced or, if no fence is present, children must be supervised at all times. The outdoor play area is fenced and has age-appropriate toys for the children such as blocks, art center, sandbox, toy kitchen and lounging area.. The licensee was reminded to notify licensing before making any changes to the house or yard.

Licensee CPR/First Aid expires 3/25/26 with mandatory training expiring 4/7/26. Assistant (A1) CPR/First Aid expires 3/25/27 and mandatory training expiring 4/2/27. Assistant 2(A2) CPR/First Aid expires 3/28/27 and mandatory training expiring 9/21/26. All documented on Review of Staff/Volunteers Records (LIC 859) LPA reminded the licensee of the two-year renewal requirement.

The facility roster and six children’s files were reviewed, confirming all required forms were complete. The licensee does not transport children. Licensee was reminded that should license elect to transport children that licensee must have current driver's license, that children cannot be left unattended in vehicles and that car seats and booster seats must be available for safe transportation.

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NAME OF LICENSING PROGRAM MANAGER: Susy Cervantes
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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: MARTINEZ, MARIA
FACILITY NUMBER: 274408357
VISIT DATE: 05/20/2025
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Safe Sleep Information was provided, and licensee was reminded that an Individual Infant Sleeping Plan (LIC 9227) is a required for each infant up to 12 months old, with nap checks documented until age two. Cribs and play yards must be free of loose items, bumper pads, and hanging objects and mattresses must be firm, properly fitted, and have fitted sheets. Additionally baby walkers, bouncers, jumpers, and similar items are not allowed.

LPA discussed the safe sleep regulations with licensee 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 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 they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was reminded 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 platforms. To receive important licensed related information to licensed facilities, inspection 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.



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)/ (8004314-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. Car seats and booster seats must be available for safe transportation.

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NAME OF LICENSING PROGRAM MANAGER: Susy Cervantes
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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: MARTINEZ, MARIA
FACILITY NUMBER: 274408357
VISIT DATE: 05/20/2025
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please inspection the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee stated that the facility is part of the Migrant Program (MHSH) and is closed during the winter season, from October through May.

During the exit interview, the Licensee confirmed no Registered Sex Offenders reside at the facility. The LPA completed the RSO profile in FAS on 5/20/25. A search of the California Attorney General-Megan’s Law website found no registered sex offenders at the facility address.

No deficiency issued during today's inspection. Appeals rights provided.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, NAME




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NAME OF LICENSING PROGRAM MANAGER: Susy Cervantes
NAME OF LICENSING PROGRAM ANALYST: Darnella Barnes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
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