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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410973
Report Date: 02/13/2025
Date Signed: 02/13/2025 03:45:51 PM

Document Has Been Signed on 02/13/2025 03:45 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:FERNANDEZ-HERNANDEZ, HILDAFACILITY NUMBER:
444410973
ADMINISTRATOR/
DIRECTOR:		HILDA FHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 768-7093
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 27CENSUS: 8DATE:
02/13/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Hilda Fernandez-HernandezTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On February 13, 2025, Licensing Program Analysts (LPA) Darnella Barnes and Licensing Program Manager (LPM) Belinda Devall conducted an unannounced Annual Random inspection at the residence of Hilda Fernandez-Hernandez licensee. The purpose of the inspection was explained, and Licensee granted access. Licensee received the Entrance Checklist (LIC 126). The home was toured to conduct a Health and Safety Inspection.

The facility operates Monday through Friday, 7:00 a.m. to 5:00 p.m. Required postings, including the Facility License, Notification of Parent's Rights (PUB 393), Emergency Disaster Plan (LIC610A), and Earthquake Preparedness Checklist (LIC 9148), were posted and visibly for review. The last fire/disaster drill date was 5/16/24; Licensee was reminded of the six-month drill and documentation requirement.

Licensee and Assistant Martha Morales were present with three infants and five preschoolers which is compliant with the home license capacity and ratio requirements. Staff-to-child ratio and supervision, including the licensee's required presence during daycare hours, were reviewed. Licensee was reminded that all suspected child abuse and other reportable incidents must be documented and reported. Children’s rights cannot be waived, even with parental consent.

Licensee confirmed all adults 18 years and older of age residing in the home and fingerprint clearances were obtained and verified by LPA on February 10, 2025.

There were three play yards that did not have mattresses with tight fitting sheets. There were blankets in the play yard with napping infants.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: FERNANDEZ-HERNANDEZ, HILDA
FACILITY NUMBER: 444410973
VISIT DATE: 02/13/2025
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LPA and LPM toured the home's indoor and outdoor areas. Off-limit indoor 2 bedrooms, master bedroom, 2 bathrooms, kitchen, living room, attached rental unit, and attached garage. Licensee has a barricaded fireplace in the home that is located in an off-limits area and is not used during day care hours. The backyard area of the home was inspected and LPA observed sufficient play-equipment and supplies for the children. There is a functioning sink located outside for children's use and hand washing. Off-limit areas outside of home include: left side yard area. No outdoor bodies of water were observed during todays inspection

Off-limit areas are secured by doors and barriers. Licensee was advised that Licensing must be notified, and an inspection arranged before using off-limit areas for daycare. Observations included a fully charged 3A-40B-C fire extinguisher last serviced 7/21/24 working smoke and carbon monoxide detectors, and a functioning telephone. The home was clean, well ventilated, and stocked with safe, age-appropriate toys. All poisons were locked, and hazardous items were secured out of children's reach. No bodies of water were observed.

Licensee was reminded that no one is allowed to smoke at the daycare. Baby walkers, bouncers, jumpers, and similar items are not allowed and must be kept away from the children. Licensee confirmed there are no guns or ammunition at the house. Licensee was also reminded to notify licensing before making any changes to the house or yard..

Licensee's CPR/First Aid certification expires on 2/22/26. The Preventive Health certification expires on 2/22/26and Safety and Mandated Reporter training certificates expires 8/8/26. LPA and LPM reminded Licensee of the two-year renewal requirement for both Mandated Reporter training and CPR/First Aid certification.

Licensee has required vaccinations MMR, Pertussis, and flu. LPA and LPM reviewed the facility roster (LIC 9040) and 5 children's files, confirming all required forms were complete, including the affidavit regarding liability insurance (LIC 282). Licensee does not have daycare insurance coverage.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
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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: FERNANDEZ-HERNANDEZ, HILDA
FACILITY NUMBER: 444410973
VISIT DATE: 02/13/2025
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LPA and LPM reminded Licensee that an individual infant sleeping plan (LIC 9227) is required for each infant up to 12 months old, and nap check documentation is required until age two.

Licensee stated that any child displaying illness or communicable disease symptoms will be isolated in the one corner of the day available until parent/guardian arrival.

The Licensee states that she does transport any day care children and has current drivers license (D1138790) that expires 4/10/2029. LPA reminded Licensee that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping. Licensee has adequate booster seats and car seats for safe transportation of children.

Licensee 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 Childcare 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 and LPM discussed safe sleep regulations with Licensee and referenced the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-sources/safe-sleep as an additional resource. LPA and LPM also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website 1 at https://www.cpsc.gov/ and recommended registering all infant devices with the CPSC for recall notifications

Licensee was reminded 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, inspection the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
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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: FERNANDEZ-HERNANDEZ, HILDA
FACILITY NUMBER: 444410973
VISIT DATE: 02/13/2025
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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)/ (8004314-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 inspection the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

During the exit interview, the Licensee confirmed no Registered Sex Offenders reside at the facility. The LPA completed the RSO profile in FAS on December 9. 2024. A search of the California Attorney General-Megan’s Law website found no registered sex offenders at the facility address.


During today’s inspection, there were several Type B deficiencies are issued on attached 809-D.

Appeals right provided.

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

Exit interview conducted and report was reviewed with the Licensee, Hilda Fernandez-Hernandez

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/13/2025 03:45 PM - It Cannot Be Edited


Created By: Darnella Barnes On 02/13/2025 at 02:54 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: FERNANDEZ-HERNANDEZ, HILDA
FACILITY NUMBER: 444410973

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as the last drill conducted in May 2024 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/27/2025
Plan of Correction
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Licensee shall provide a copy of fire and disaster drill conducted this month.
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as there was no documentation for three napping infants for the 15 minute checks for infants sleeping which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/27/2025
Plan of Correction
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Licensee shall provide a copy of the infant safe sleep check for the three infants documenting the name of the infant, date and time checked and comment section.
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:Belinda Devall
LICENSING EVALUATOR NAME:Darnella Barnes
LICENSING EVALUATOR SIGNATURE:
DATE: 02/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2025


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Document Has Been Signed on 02/13/2025 03:45 PM - It Cannot Be Edited


Created By: Darnella Barnes On 02/13/2025 at 03:08 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: FERNANDEZ-HERNANDEZ, HILDA
FACILITY NUMBER: 444410973

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)(3)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as the play yards does not have a mattress with tight fitting sheet which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/27/2025
Plan of Correction
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Licensee will obtain a firm mattress for each play yard with a tight fitted sheet for napping infants
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Belinda Devall
LICENSING EVALUATOR NAME:Darnella Barnes
LICENSING EVALUATOR SIGNATURE:
DATE: 02/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2025


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