<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 354415630
Report Date: 11/20/2024
Date Signed: 11/20/2024 01:09:57 PM

Document Has Been Signed on 11/20/2024 01:09 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:ABREGO, GRISELDAFACILITY NUMBER:
354415630
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
11/20/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:18 AM
MET WITH:Griselda AbregoTIME VISIT/
INSPECTION COMPLETED:
01:15 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
On 11/20/2024 at 09:15 AM, Licensing Program Analyst (LPA) Teodoro Trujillo met with licensee, Griselda Abrego for a case management to increase capacity from eight (8) to 14. Present were licensee and her adult son and adult nephew with 2 daycare children: One (1) infant, One (1) preschool age. Previous to today's visit, LPA received a Fire Clearance from the Hollister Fire Department (HFD), inspection was conducted and approved on 10/17/2024.

LPA observed that required postings were posted. LPA, along with the licensee toured the inside and outside of the home. LPA observed that there were age-appropriate toys and furniture. LPA observed cots and one crib for the children's use.

A pre-licensing inspection was conducted on 02/14/23. LPA inspected the second exit for the home. LPA observed a 3A40BC fire extinguisher that was serviced on 01/29/2024, combination smoke and carbon monoxide detectors were operable. Licensee has current CPR and first aid that expires on 01/20/25. Mandated Reporter training is current and was taken on 01/24/23. LPA observed no fireplace and wall heaters in the home. LPA observed barricaded stairs leading to second floor of the home. LPA observed a child fence separating the kitchen with dining room and front door entrance. Licensee stated there are no weapons in the home. Licensee stated there are no pets in the home. LPA observed the attached garage is not approved for use by HFD fire clearance, dining room, family room, hallway bathroom and fenced back play yard area are approved for day care use. LPA reviewed with licensee their ratio/capacity for a large FCCH as well as assistant requirement. LPA observed her adult nephew has obtained background clearance without the child abuse central index(CACI).
Supervision of children was discussed with Licensee, and he understands that he or a qualified adult must be present in the home during day care hours and ensure that the children are supervised at all times. LPA discussed the requirement for Licensee to be present at the facility 80 percent of the hours the facility is in operation and that temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. Licensee understands the capacity options and she understand that she cannot have more than 14 children in the home at any time and a qualified assistant must be present. Licensee understands in absence of a helper the license capacity is reduced to 8 and ratio (age of the children) must be observed.

Type B Deficiencies were cited today. 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.


Exit interview was conducted and report was reviewed with Licensee, Grselda Abrego. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. A notice of site visit was given and must remain posted for 30 days.

LPA informed licensee that an increase of capacity to a large family childcare home is approved pending the following:

-Management's approval with criminal background clearance for adult nephew.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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 2
Document Has Been Signed on 11/20/2024 01:09 PM - It Cannot Be Edited


Created By: Teodoro Trujillo On 11/20/2024 at 12:35 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: ABREGO, GRISELDA
FACILITY NUMBER: 354415630

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/04/2024
Section Cited
HSC
1596.871(c)(1)(A

1
2
3
4
5
6
7
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee's nephew will submit proof that her nephew has completed the live scan process by the end of business day of 12/04/2024 to SJRO.
8
9
10
11
12
13
14
Based on interview and record review, the licensee did not comply with the section cited above in lsidro Abrego, does not have CACI fingerprint clearance. Licensee stated her nephew lives in the home which poses/posed a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Susy Cervantes
LICENSING EVALUATOR NAME:Teodoro Trujillo
LICENSING EVALUATOR SIGNATURE:
DATE: 11/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/20/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2