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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274417859
Report Date: 10/09/2024
Date Signed: 10/09/2024 12:54:18 PM

Document Has Been Signed on 10/09/2024 12:54 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:FLETES, MARIAFACILITY NUMBER:
274417859
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/09/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Maria Fletes GarciaTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Martha Jimenez-Villanueva conducted an announced pre-licensing inspection on October 9, 2024. LPA observed Applicant lives in a one story home. LPA met with Maria Fletes Garcia, Applicant, and explained the nature of today's inspection. Present at home was the applicant. The Applicant states that herself, her husband and her two daughters are the only adults at home and her three children (13, 10 and 4 year old) and nephew (17 year old) at home.

Days and hours of operation will be Monday - Saturday from 5:00 AM to 6:00 PM. Applicant completed her Preventative Health and Safety Training on 07/15/2024 and a copy of the certification is on file. Applicant's CPR and First Aid certifications are current and expire on 08/2026. Applicant completed the Mandated Reporter Training on 08/09/2024 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 as a proof of property applicant submit Grant Deed that 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 until she obtains liability insurance in the future.

LPA toured the indoor and outdoor areas of the home with the Applicant. There are not stairs and heating units inside the home located in the garage. Off Limits areas inside the home include: 4 bedrooms, 1 bathroom and garage. Off limit areas outside include front yard, left driveway of the house and the orchard backyard with two storages. On limits areas include living and dining room, kitchen, right driveway and backyard with cement and grass backyard. The Orchard backyard is barricaded. The backyard is fenced. LPA observed a jumper that will be use for children, applicant states always will supervise children and will use for appropriate ages. Applicant states will use the cement and grass backyard as play area and outdoor activities.

LPA observed the home is clean and orderly. LPA observed fireplace is barricaded. Applicant has a working cellphone. LPA observed there are not bodies of water and no weapons at home. LPA observed a dog in the right corner of the backyard in a locked dog cage, applicant states dog stay outside of the home and the dog is vaccinated. There are sufficient toys, supplies, and equipment for the day care children indoors.
Report Continues in 809-C page 2
SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: FLETES, MARIA
FACILITY NUMBER: 274417859
VISIT DATE: 10/09/2024
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Report 809-C page 2
LPA observed fully charged fire extinguisher 3A40BC, working a combo smoke and carbon monoxide detector. stands that prior to making any change related to the on or off limits must be reported to Licensing. Cleaning products, toxic agents, medications, and sharp objects are inaccessible to children these products are located in a top cabinet in the kitchen and laundry area and in the garage.

LPA 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 front corner of the dining room if necessary due to illness or communicable disease. Applicant has a First Aid kit.

Forms of discipline applicant will use: Communication with children and redirection. Applicant understands that children's personal rights should not be violated, including no corporal punishment. Supervision of children, capacity options for a small license, transportation of children, applicant will not transport children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed. LPA informed Applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

LPA discussed the requirements of AB 633 with the Applicant. LPA also discussed "Zero tolerance" related regulations with the Applicant.

A review of staff records on 09/27/2024 indicates that all the adults residing in the home or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. 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.

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

Report Continues in 809-C page 3

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: FLETES, MARIA
FACILITY NUMBER: 274417859
VISIT DATE: 10/09/2024
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Report 809-C page 2
LPA reviewed with 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. Entrance Checklist LIC 9280 was provided to the applicant.

LPA discussed the safe sleep regulations with Applicant and, discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed Applicant, 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.

On this date, 09/11/2024 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 childcare by connecting them to childcare 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 Fletes Garcia in Spanish.

The applicant was informed that a small Family Child Care Home license has been approved effective October 9, 2024.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
LIC809 (FAS) - (06/04)
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