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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274416856
Report Date: 04/09/2024
Date Signed: 04/09/2024 05:20:51 PM

Document Has Been Signed on 04/09/2024 05:20 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:FERNANDEZ-ORTIZ, MARISAFACILITY NUMBER:
274416856
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/09/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:10 PM
MET WITH:Marisa Fernandez-OrtizTIME VISIT/
INSPECTION COMPLETED:
05:30 PM
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Licensing Program Analysts (LPAs), Cortney Nelson and Andrea Cortez, met with Licensee, Marisa Fernandez-Ortiz, to conduct pre-licensing inspection for change of location and capacity increase. Upon arrival, LPAs were admitted into the home by Marisa and toured inside and outside during todays inspection.

The operating hours for the Family Child Care Home (FCCH) will be Monday - Friday from 6:00AM-6:00PM. The FCCH will care for children ages 6 months through fourteen years of age. Marisa states that adults, over the age of 18, residing in the home are herself and her partner (Enrique). There are two minor children living in the home. LPAs advised that children living in the home will be included in the home ratio and capacity until they turn 10 years of age. Marisa has submitted proof of control of property for the home and she states that she is planning to purchase liability insurance for the day care. LPAs advised Marisa to complete Affidavit Regarding Liability Insurance for Family Day Care Home (LIC282) if she begins caring for children prior to purchasing liability insurance.

Marisa was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

LPAs toured inside the home and observed sufficient materials and play equipment for day care children. There are a variety of toys for the children to play with, including stuffed animals, activity table, and pushing toys such as grocery carts and plastic fire truck. Marisa states that she still needs to purchase tables, chairs, and additional toys for the day care children. LPAs advised Marisa to consider adding baby gates to section off the home as it is currently open space in design. There is a wood burning stove (fire place) located in the living room that is properly barricaded. The home has a built in heating system and Marisa states that she has AC units that could be used if necessary. Off limits inside the home include: three (3) bedrooms, one (1) bathroom, and two (2) closets. LPAs observed the bedroom doors and closets were locked and Marisa states that they will remain locked during day care hours. LPAs advised if there are changes to the on/off limits of the home to submit an updated facility sketch (LIC999A) to the San Jose Regional Office.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: FERNANDEZ-ORTIZ, MARISA
FACILITY NUMBER: 274416856
VISIT DATE: 04/09/2024
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There is a working telephone (cellphone) at the FCCH. Marisa states that she currently is planning to purchase nap mats/cots and has one (1) crib available for use. LPAs advised mats/cots shall be equipped with a sheet and cribs/pack n play sheets shall be changed in between each use if different infants are using them. Marisa states that she has a diaper changing table that she will place in the day care area for changing diapers and a waste bin with a tight fitting lid for disposal. Marisa states that she will assist with potty training if needed. For hand drying, Marisa states that she will use wash cloths and LPAs advised changing the cloths when wet and ensuring they are sanitary for use by multiple children.

Marisa states that she will provide medication and Incidental Medical Services to children as needed. Children in care will provide their own food and Marisa states that she is planning to work with food programs. LPAs advised refrigerating perishable food that are brought to the FCCH. Water will be provided to the children via plastic water jug and children's water bottles. LPAs observed kitchen knives are placed on the back of the counter and LPAs advised storing the knives and similar items, such as blenders, to be inaccessible to children. There is a functioning carbon monoxide detector, smoke detector, and fully charged 3A40BC fire extinguisher.

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)/ (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

A fire clearance for the home was approved on 3/18/2024 by the North County Fire District. The clearance indicates that the off-limits areas are the garage, parking area, front yard, front area, and backyard. The outside area of the home was inspected and Marisa states that she is currently not using the outside area. Marisa further states that she is planning to utilize the sun room in the home as the "outside area" for children until she can add proper fencing. Off-limits outside of the home include: detached garage and laundry room building. There is a water pond feature that has been emptied and LPAs advised that any accessible bodies of water shall have a gate surrounding it that is at least five feet tall. If a door is added to the gate, it shall swing away from the body of water, self close, and have a latching device no more than six inches away from the top of the gate.

LPAs discussed isolation of sick children with Marisa and she states that if a child were to start feeling sick at her home that she would isolate the child in the living room with a nap mat, until the parent/guardian arrives to pick-up. LPAs discussed isolation strategies, such as using a baby gate, and utilizing the restroom if the child's symptoms need close restroom access. LPAs observed Marisa has a first-aid kit, and thermometer, available in her home.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: FERNANDEZ-ORTIZ, MARISA
FACILITY NUMBER: 274416856
VISIT DATE: 04/09/2024
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LPAs reviewed supervision of children and requirements for additional staff/ adults living in the home. Marisa states that she is unsure if she will transport children and LPAs advised if she does that she must maintain current car insurance, vehicle registration, and CA drivers license. LPAs additionally advised that all adults alone with the children shall maintain current first-aid/CPR certifications.

For discipline strategies, Marisa states that she will talk to the child, calm them down, and explain about their behavior and why it was not okay. She states she does not plan to utilize time-outs and LPAs advised that if used, should not exceed one minute per year of age of the child. LPAs discussed using a "calming corner" for the children in care and advised that children's personal rights may not be violated and corporal punishment may not be used.

LPAs reviewed large family child care home capacity requirements with Marisa and provided a copy of 102416.5 Staffing Ratio and Capacity from California Code of Regulations. LPAs advised that there should never be more than four infants, children under two years of age, present at the FCCH. If no assistant is present, then the FCCH shall comply with the capacity requirements for a small FCCH. LPAs advised that an assistant shall be at least 14 years old and, if under the age of 18, shall never be left alone with day care children.

LPAs discussed the safe sleep regulations with the Licensee and provided 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.

Marisa 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.

Exit interview conducted and report was reviewed with the Applicant, Marisa Fernandez-Ortiz.

LPAs advised Marisa that a large FCCH license will be issued pending manager review/approval and submission of the following corrections:
-Proof of purchase for additional nap mats/cots, tables, and chairs for day care children
-Add lock to the bathroom for cleaning supply storage
-Add additional toys to the sun room if going to be used by children and submit photos
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC809 (FAS) - (06/04)
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