274450146-5-5-2022-07-CC-FCJO-CE5SRZ-20220505140710

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 274450146
Report Date: 05/05/2022
Date Signed: 05/05/2022 02:07:21 PM

Document Has Been Signed on 05/05/2022 02:07 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:	REGALADO, BERENICE		FACILITY NUMBER:	274450146
ADMINISTRATOR:	BERENICE REGALADO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 633-5163
CITY:	CASTROVILLE	STATE: CA	ZIP CODE:	95012
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 8	DATE:	05/05/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Berenice Regalado		TIME COMPLETED:	02:15 PM

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 Analyst (LPA) Fermin Campos-Jaramillo conducted an unannounced annual inspection today. LPA met with Berenice Regalado, Licensee, and explained the nature of today's inspection to her. Present today was Licensee's son Oscar. LPA observed there were eight children in care today, included three infants and five preschool age. Days and hours of operation are Monday to Friday from 5:30 AM to 5:30 PM and Saturdays 5:30 AM to 2:30 PM. The adults that reside in the home are the Licensee, her spouse Leonel, and her sons Oscar and Alejandro. Licensee's certifications for CPR and First Aid card are current and will expire on 9/19/22 for both licensee and Oscar. Licensee documented a fire drill on 4/22/22. LPA obtained a copy of the children's roster and it is not complete. LPA reviewed eight children's files which include parent's rights form and immunization records form. LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Off limit areas inside are: 3 bedrooms, one bathroom and the attached garage. LPA observed there are no stairs inside the home. Off limits areas outside: Right side of the back yard and the storage in the back yard. The back yard is fenced and the licensee uses a section as playground whenever the weather allows it. LPA observed a fully charged 3A40BC fire extinguisher last time serviced on 9/01/21 and at least one working smoke detector. LPA observed the home has a working carbon monoxide detector and no bodies of water. LPA observed there are not wall heaters. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, medications, and other similar items are stored inaccessible to children. LPA discussed Incidental Medical Services (IMS) with the Licensee. LPA observed licensee has proof of immunization in file for measles, pertussis and influenza according with the SB792. Report dated 5/05/22 continues on page 2.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

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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Document Has Been Signed on 05/05/2022 02:07 PM - It Cannot Be Edited

Created By: Fermin Campos-Jaramillo On 05/05/2022 at 01:23 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: REGALADO, BERENICE	FACILITY NUMBER: 274450146
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(8)

Operation of A Family Child Care Home

(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Licensee has not completed the children's roster. which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/19/2022
	Plan of Correction
1 2 3 4

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:

Mary Segura

LICENSING EVALUATOR NAME:

Fermin Campos-Jaramillo

LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

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: REGALADO, BERENICE	FACILITY NUMBER: 274450146
	VISIT DATE: 05/05/2022

NARRATIVE

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Report dated 5/05/2022 continues from page 1.
Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. The Licensee understands her capacity options and she understands that she cannot have more than 14 children in the home at any time, and a helper must be present. Licensee understands that in absence of a helper her license's maximum capacity will be maximum 8 children (small license) and ratio (age of the children) must be observed. Licensee states that she does not transport children via vehicle and that she understands that children cannot be left in parked vehicles unattended at any time. Licensee stated she uses redirection and communication with children as a form of discipline.

Department website: www.ccld.ca.gov provided to Licensee.
LPA discussed the requirements of AB 633 whenever a Type A deficiency is cited. LPA also discussed "zero tolerance" related regulations with the Licensee.
LPA observed licensee and her helper have renewed the Mandated Reporter training on 4/10/22 and 4/25/22 respectively. Licensee understands the training is to be renewed every two years. LPA referred the Licensee to the training website: www.mandatedreporterca.com for additional information on the online training.
LPA observed that Guardian Program has not granted a clearance to Rosario Chavez. LPA observed Rosario is not present in the home today. Licensee Berenice stated Rosario has not been in the home and will not start coming until she obtains a criminal records clearance or an exemption.

A review of staff records on 5/04/22 indicates that not all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Licensee Berenice Regalado 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.

***********************Report dated 5/05/22 continues on page 3.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

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: REGALADO, BERENICE	FACILITY NUMBER: 274450146
	VISIT DATE: 05/05/2022

NARRATIVE

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Report dated 5/05/22 continuers from page 2.

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

LPA also informed licensee 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.

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

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.

Exit interview conducted and report was reviewed with the licensee Berenice Regalado.

One type B deficiency was cited today.

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

Licensee was informed that failure to correct the deficiencies by the specified Plan of Correction Due Date will result in assessment of civil penalties in the amount of $100 per day per violation until the correction is made.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Fermin Campos-Jaramillo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

LIC809 (FAS) - (06/04)

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