444410331-10-9-2024-07-CC-TTRO-D9VQTM-20241009122722

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444410331
Report Date: 10/09/2024
Date Signed: 10/09/2024 12:27:37 PM

Document Has Been Signed on 10/09/2024 12:27 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:	QUIROZ, LUZ		FACILITY NUMBER:	444410331
ADMINISTRATOR/ DIRECTOR:	LUZ QUIROZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 724-3178
CITY:	WATSONVILLE	STATE: CA	ZIP CODE:	95076
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	10/09/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Luz Quiroz		TIME VISIT/ INSPECTION COMPLETED:	12:45 PM

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On 10/09/24 at 09:04 AM, Licensing Program Analyst (LPA) Teodoro Trujillo met with licensee Luz Quiroz, for an annual inspection. Present with licensee were adult male tenant, licensee 17 year old daughter, and assistant, with 10 children: seven (7) preschool age, three (3) infants, one preschool and one infant arrived during site visit. Adults living in the home are licensee, her spouse, two adult tenants and her one 17-year-old minor child. Days and hours of operation are Monday through Friday 06:00 AM to 06:00 PM.

A listing of staff criminal record clearances associated to this facility in the CCL Licensing Information System (LIS) on 09/23/2024 was reviewed and it indicates that all Facility staff or other individuals who require caregiver background clearances have received criminal record and child abuse index clearances or exemptions. Licensee Luz Quiroz was reminded that all adults 18 and over living or working in the home, 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.

LPA inspected inside and outside of single-story home. Licensee owns the home and Licensee states she has liability insurance with Markel Insurance Company for a family childcare home (FCCH). LPA observed a 3A40BC fire extinguisher last 2/2/2024. Carbon Monoxide and smoke detectors are operable. LPA observed no wall heaters in the home, a wood burning stove is barricaded in the home. Licensee stated there are no firearms/weapons in the home. Sharp objects, medicines, poisons, and cleaning supplies are inaccessible to the children. Backyard is fenced. LPA observed a water fountain that is empty in the gated rear off limit backyard. Off limits indoor: master bedroom with master bath, two bedrooms, and the attached converted garage, licensee states she does not have permit for garage conversion. Off Limit outdoor: gated rear yard, locked storage shed, and right yard area. Licensee states she has a small vaccinated dog in the home.

Children were supervised during the visit and LPA went over substitute options and reminded licensee they could only have 14 children according to her license. 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.

Continues report dated 10/09/2024 pg. 1/3

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
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)

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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: QUIROZ, LUZ	FACILITY NUMBER: 444410331
	VISIT DATE: 10/09/2024

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Continuation of report dated 10/09/2024 pg. 2/3

LPA observed a current roster of the children. LPA observed a fire and disaster drill log last performed on 10/08/2024. LPA reviewed 6 children’s files and observed all required documentation was in compliance. Infant individual sleeping plan (LIC 9227) for each infant under 12 months was discussed. LPA observed licensee completed Mandated Reporter Training on 1/11/24 and assistant 3/11/24. Licensee has Pediatric CPR/1^st Aid expiring on 01/16/2025 and assistant 2/2026. Needed documentation for SB 792 which requires immunization against Pertussis, Measles, and Influenza as well as TB testing is current for licensee, and all adults residing in the home.

Incidental Medical Services (IMS) policy was discussed with the licensee. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The licensee is providing IMS currently. Licensee will submit an updated plan of operation if in the future they provide any IMS services to a child in care.

LPA discussed the safe sleep regulations with licensee Luz Quiroz 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 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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Continues report dated 10/09/2024 pg. 2/3

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
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)

Page: 2 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: QUIROZ, LUZ	FACILITY NUMBER: 444410331
	VISIT DATE: 10/09/2024

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Continuation of report dated 10/09/2024 pg. 3/3

Licensee Luz Quiroz was informed of the MyChildCarePlan.org website; 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.

During the exit interview, the Licensee Luz Quiroz, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No Deficiencies were cited during today's visit.

Exit interview conducted and report was reviewed with the licensee Luz Quiroz.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Teodoro Trujillo
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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