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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410976
Report Date: 03/16/2023
Date Signed: 03/16/2023 10:40:54 AM

Document Has Been Signed on 03/16/2023 10:40 AM - 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:GARCIA, KARINAFACILITY NUMBER:
444410976
ADMINISTRATOR:KARINA GARCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 761-0338
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 4DATE:
03/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:16 AM
MET WITH:Karina GarciaTIME COMPLETED:
10:50 AM
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Licensing Program Analysts (LPAs), Cortney Nelson and Farida Raja, met with Licensee, Karina Garcia, for an unannounced Required- 1 Year Inspection. LPAs were granted access to the home by the Licensee and toured both indoors and outdoors during the inspection. Upon arrival, there were three preschool-age children and one additional child arrived during todays inspection. There were a total of four preschool-age children and the Licensee present, which is compliant with the home license capacity and ratio requirements. LPAs observed all required postings near the entrance to the home and the hours of operation are Monday – Friday, 6:00AM-6:00PM.

The Licensee states that adults, over the age of 18, residing in the home are: herself and her spouse (Salomon). All adults residing in the home have Criminal Background Check Clearance and proof of negative tuberculosis (TB) test.

The Licensee 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.

LPAs reviewed facility roster (LIC9040) and fire/disaster drill log and observed the last fire drill was conducted on 3/15/2023, which is compliant with the six-month requirement for homes. LPAs observed a fully charged 3A40BC fire extinguisher (last serviced: 1/2023), functioning smoke detector and carbon monoxide detector. Licensee states that she does not currently have any children in care who require Incidental Medical Services and does not administer medication at this time. There are no weapons or firearms in the home.

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 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
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2023
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: GARCIA, KARINA
FACILITY NUMBER: 444410976
VISIT DATE: 03/16/2023
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Indoor areas of the home were inspected by the LPAs today and observed to be clean, orderly, and safe for the day care children. Off-limits inside the home include: attached garage, kitchen, three bedrooms, living room, and dining room . LPAs observed a portable space heater was being used to warm the room and is located inaccessible to children. The Licensee states that she works with Community Bridges Food Program and serves the children breakfast, AM snack, lunch, and dinner. The Licensee additionally states that she works with PVUSD, Go Kids, Migrant Head Start, and Early Development Services. The bathroom in the home is clean, sanitary, and operable. There is a working telephone in the home.

The backyard area of the home was inspected and observed to be fenced in. There are a variety of materials for children to play with and the outside area is covered to provide shade. The Licensee states that due to rainy conditions, the outside area is temporarily not in use. Off-limit areas outside of home include: left side yard and all areas outside of fenced play area for children. No outdoor bodies of water were observed.

Four (4) children’s files were reviewed during todays inspection and all required documents were present, including Notification of Additional Children in Care (LIC9150). The Licensee's file was reviewed and all required documents were present. She has current CPR/First-Aid that expires 3/8/2024 and Mandated Reporter Training that expires on 1/21/2024. LPAs reminded that both trainings must be renewed every 2 years.
The Licensee states that she does not transport any day care children. LPAs reminded that children should not be left unattended in parked vehicles and that car seats shall only be used for transportation, not for sleeping.

Exit interview conducted and report was reviewed with the Licensee, Karina Garcia.

As a result of todays inspection, no deficiencies were cited.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

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.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
LIC809 (FAS) - (06/04)
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