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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274413881
Report Date: 03/02/2023
Date Signed: 03/02/2023 12:34:28 PM

Document Has Been Signed on 03/02/2023 12:34 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:ANAYA, HORTENCIAFACILITY NUMBER:
274413881
ADMINISTRATOR:ANAYA, HORTENCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 722-4573
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 5DATE:
03/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:13 AM
MET WITH:Hortencia AnayaTIME COMPLETED:
12:47 PM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Licensee, Hortencia Anaya, for an unannounced Required- 1 Year Inspection. LPA was granted access to the home by the Licensee's Mother, Maria, and toured both indoors and outdoors during the inspection. Upon arrival, there were five (5) preschool-age children, the Licensee and her Mother present, which is compliant with the home license capacity and ratio requirements. LPA observed all required postings near the entrance to the home and the hours of operation are Monday – Friday, 5:00AM-6:00PM.

The Licensee states that adults over the age of 18, residing in the home are: herself, her mother (Maria), her father (Gustavo), and her sister (Lizet). All adults residing in the home have Criminal Background Check Clearance.

The 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.

LPA reviewed facility roster (LIC9040) and fire/disaster drill log and observed the last drill was conducted on 1/26/2023, which is compliant with the six-month requirement for homes. LPA observed a fully charged 2A10BC fire extinguisher (last serviced: 2/2023), functioning smoke detector and carbon monoxide detector. Licensee states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. There are no weapons or firearms in the home.

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 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
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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: ANAYA, HORTENCIA
FACILITY NUMBER: 274413881
VISIT DATE: 03/02/2023
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Indoor areas of the home were inspected and observed to be clean, orderly, and safe for the day care children. Off-limits areas inside the home include: 2 bedrooms and a closet. There are no open-faced heaters in the home. LPA observed sufficient age-appropriate materials, toys, and play equipment in the home. The Licensee states that she works with Go Kids, Cabrillo College, and Migrant Head Start. Additionally, the Licensee states that she works with Community Bridges Food Program and provides breakfast, lunch, and AM/PM snack to the children in care. The bathroom in the home is clean, sanitary, and operable. There is a working telephone in the home.

The outside area of the home was inspected. The Licensee states that due to on-going rainy weather conditions, she is not currently utilizing the outside space. Off-limit areas outside of home include: shed and area outside of fenced area for children. No outdoor bodies of water were observed during todays inspection.

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.

Four (4) children, the Licensee, and Assistant files were reviewed during todays inspection and all required documents were present. The Licensee has current CPR/First-Aid that expires 2/11/2025 and Mandated Reporter Training that expires on 2/18/2024. LPA reminded that both trainings must be renewed every 2 years.

Supervision of children was discussed with the Licensee and she understands that she must be home during day care hours and ensure that children are supervised at all times. The Licensee states that she does not transport any day care children.

Exit interview conducted and report was reviewed with the Licensee, Hortencia Anaya.

As a result of todays inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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