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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444406791
Report Date: 12/16/2022
Date Signed: 12/21/2022 01:47:35 PM

Document Has Been Signed on 12/21/2022 01:47 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:VALENCIA, GRISELDAFACILITY NUMBER:
444406791
ADMINISTRATOR:VALENCIA,GRISELDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 728-2940
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
12/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Griselda ValenciaTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Elizabeth Berumen conducted an unannounced 1 year required inspection. LPA met with licensee, Griselda Valencia, and explained the nature of today's inspection to her. Days and hours of operation are Monday to Friday from 7:00 AM to 5:00 PM. The adults that reside in the home are the Licensee, her spouse Uriel, and her adult daughter Nallely and son, Alexis. LPA observed 4 preschoolers during today's inspection.

LPA inspected the indoor and outdoor areas of the home during today's inspection. The off limit areas are the two bedrooms, fenced back yard adjacent to children's play area located behind the house. Right side yard is used for Parents entry. The licensee uses the garage as passage to go to the play room. There are no bodies of water. Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children are stored where they are inaccessible to children. Licensee states there are no weapons in the home and no pets. LPA reminded Licensee that any poisons need to be stored inaccessible to children and locked. LPA observed a fully charged 2A10BC fire extinguisher. The smoke and carbon monoxide detectors were tested and proved to be functioning. LPA observed there is one barricaded wood burning stove and one barricaded wall heater in the home.

LPA reviewed four children files and observed files are complete. LPA observed last fire drill was practiced and documented on 09/20/2022.

The Licensee has a working telephone in the home (land line) and provided her cell phone number (831) 291-8563. LPA observed sufficient materials, toys, and play equipment for the day care children.

Report dated 12/16/2022 continues on page 2.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2022
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
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: VALENCIA, GRISELDA
FACILITY NUMBER: 444406791
VISIT DATE: 12/16/2022
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Licensee stated she does not transport children, LPA reminded Licensee that children are never to be left in parked vehicles and must use appropriate car seats according to the child's age/weight/size.

LPA reviewed a current Child Care Facility Roster during today's inspection. Licensee has the required vaccines (MMR, Tdap, & declines the flu vaccine) The Mandated Reporter Training for Child Care Workers expires 06/11/2023. Certification for CPR and First Aid Card for Licensee is current and will expire on March 2023.


LPA discussed the safe sleep regulations with the 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 the 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.

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, Griselda Valencia.

No deficiencies issued during today's inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022
LIC809 (FAS) - (06/04)
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