274417674-11-1-2023-07-CC-JBOT-CX6PQ3-20231101113028

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274417674
Report Date: 11/01/2023
Date Signed: 11/01/2023 11:30:41 AM

Document Has Been Signed on 11/01/2023 11:30 AM - 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:	GARCIA, MARIA		FACILITY NUMBER:	274417674
ADMINISTRATOR:	MARIA GARCIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 821-9231
CITY:	KING CITY	STATE: CA	ZIP CODE:	93930
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	11/01/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Maria Garcia		TIME COMPLETED:	11:40 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPAs) Jessica Bongardt and Mel Matos met with Maria Garcia, Applicant, to conduct an announced Prelicensing inspection at 801 King Street, King City CA 93930. LPAs note that Applicant resides in a Home that faces King Street. LPAs were granted access to the home by the Applicant. Applicant was the only adult present in the home during today's inspection. Applicant and Applicant's Adult Child (Heaven Pineda) are the only adults residing in the home. Applicant has one minor 16 year old child (Michael Pineda) residing in the home. Days and hours of operation will be Monday-Sunday from 12:00 AM to 11:59 PM. Applicant completed her Preventative Health and Safety Training on 08/01/2023 and a copy of the certification is on file. Applicant's CPR and First Aid certifications are current and expire on 10/14/2025. Applicant completed the Mandated Reporter Training for Child Care Workers on 07/24/2023 and a copy of the certification is on file. A copy of current TB test, MMR, Tdap, and flu vaccinations for the Applicant are on file. Applicant owns the home and a copy of the grant deed verifying home ownership is on file. Applicant does not have liability insurance at this time and will issue Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282) to all enrolling families unless she obtains liability insurance in the future. LPAs toured the indoor and outdoor areas of the home with the Applicant during today's inspection. There are no stairs and wall heater units inside the home. Off limit areas inside the home: master bedroom, one bathroom, two bedrooms, barricaded fireplace, hallway closet, and attached garage. Off limit areas outside the home: right side area of the home and the front yard. Applicant has a lemon tree in the backyard that needs to be trimmed so that children don't have access to the sharp thorns on the branches. The home is clean, orderly, including heating and air conditioning, for safety & comfort. Applicant has a valid phone in the home (#831-821-9231). LPAs observed a fully charged fire extinguisher (2A10BC), working combo smoke & carbon monoxide detectors, no bodies of water, and fenced backyard. Applicant does not have sufficient toys, play equipment, and materials for day care children. Applicant states that she does have a pet (cat) and knows that the food, water, and litter box are to be kept out of reach of children. Applicant states that she does not have any weapons/ammunition in the home.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GARCIA, MARIA	FACILITY NUMBER: 274417674
	VISIT DATE: 11/01/2023

NARRATIVE

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Cleaning Products, toxic agents, medications, and sharp objects were inaccessible to children. LPAs reminded Applicant that smoking, baby walkers, and similar items are not allowed in Family Child Care Homes. Applicant states that she will not administer any medication to the children at this time. Applicant states that a child will be isolated in the main living room if necessary due to illness or communicable disease. Applicant has a First Aid kit in the home; however, she does not have a touch less thermometer.

Forms of discipline to be used by Applicant: talking to children & redirection. Applicant would also talk with the parent and have them help in the behavior issues. Applicant understands that children's personal rights should not be violated, including no corporal punishment. isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed. LPAs informed the Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

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) or (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.

Maria Garcia Applicant, 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, 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 Child Care 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.

LPAs reviewed with Maria Garcia, Applicant, the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Prelicensing Entrance Checklist – Family Child Care Homes (LIC 9280) was provided to the Applicant.

LPAs discussed the safe sleep regulations with Maria Garcia, Applicant, and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed [applicant, licensee, or facility representative] 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.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023

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: GARCIA, MARIA	FACILITY NUMBER: 274417674
	VISIT DATE: 11/01/2023

NARRATIVE

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On this date, 10/31/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, 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.

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, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Applicant, Maria Garcia. LPAs advised the Applicant that a large Family Child Care Home license will be approved upon completion of the following:

1) Touch-less Thermometer is obtained for the first aid kit
2) Applicant does not have sufficient toys, play equipment, and materials for day care children.
3) The lemon tree branches have been trimmed so that children don't have access to sharp thorns.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Jessica Bongardt
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023

LIC809 (FAS) - (06/04)

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