274409344-8-29-2024-07-CC-ACOZ-D8LTVR-20240829150423

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274409344
Report Date: 08/29/2024
Date Signed: 08/29/2024 03:04:31 PM

Document Has Been Signed on 08/29/2024 03:04 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:	HUGHES, ELLA		FACILITY NUMBER:	274409344
ADMINISTRATOR/ DIRECTOR:	ELLA HUGHES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 917-3053
CITY:	SEASIDE	STATE: CA	ZIP CODE:	93955
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 8	DATE:	08/29/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:20 AM
MET WITH:	Ella Hughes		TIME VISIT/ INSPECTION COMPLETED:	03:20 PM

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Licensing Program Analyst (LPA) Andrea Cortez conducted an unannounced Required - 1 Year Inspection. LPA was greeted and granted entrance by the Licensee Ella Hughes. The purpose of today’s inspection is to ensure the home is in compliance with Title 22 California Code of Regulations. Today’s census is 8: 6 preschoolers and 2 infants. The Licensee is the only adult residing in the home. The day care hours of operation are Monday - Friday, 7am – 5:30pm. The Licensee CPR/First Aid are current and expire October 2024. The Licensee's fees are current.

LPA toured the indoor and outdoor areas of the home during today's visit. LPA reviewed a current Childcare Facility Roster and Fire/Disaster drill log during today's visit. The last fire disaster drill was conducted on June 10 2024. 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. The LPA did not observe a wall heater as the home has central heat. LPA observed a securely barricaded fireplace in the home. Off limit areas of the home: master bedroom, and garage.

LPA observed a fully charged 2A10BC fire extinguisher, working smoke, and carbon monoxide detectors, and no bodies of water. The Licensee states there are no weapons or firearms in the home. All detergents, cleaning compounds, poisons, medications, and other similar items are out of reach and inaccessible to children. Licensee states no medication currently administer.

Supervision of children was discussed with the Licensee; LPA explained section 102417(a) Operation of a Family Childcare Home as stated in the Title 22. “The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.”

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

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: HUGHES, ELLA	FACILITY NUMBER: 274409344
	VISIT DATE: 08/29/2024

NARRATIVE

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The Licensee understands the current 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 his reference. The Licensee states that she does transport children; she understands that children cannot be left in parked vehicles unattended any time.

LPA observed staff immunization records and Mandated Reporter Training

LPA discussed the safe sleep regulations with the License and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Ella Hughes 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.

A review of staff records on August 29 2024, indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/29/2024 03:04 PM - It Cannot Be Edited

Created By: Andrea Cortez On 08/29/2024 at 02:21 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: HUGHES, ELLA	FACILITY NUMBER: 274409344
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(e)

Staffing Ratio and Capacity

(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above. Upon LPA arrival the Licencee was operating out of ratio. Total census: 2 infants under 24 months and 6 children under 5 years of age with no assistaant present. This deficient poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 08/30/2024
	Plan of Correction
1 2 3 4	Licensee to submit a written statement ensuring compliance to CCR 102416.5(e). Please send Plan of Correction (POC) to LPA by 8/29/24

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Gladys Kuizon

LICENSING EVALUATOR NAME:

Andrea Cortez

LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

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: HUGHES, ELLA	FACILITY NUMBER: 274409344
	VISIT DATE: 08/29/2024

NARRATIVE

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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

One A deficiencies cited see 809-D. Exit interview conducted and report was reviewed with the Licensee Ella Hughes.

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

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024

LIC809 (FAS) - (06/04)

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