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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444410976
Report Date: 01/22/2025
Date Signed: 01/22/2025 01:18:18 PM

Document Has Been Signed on 01/22/2025 01:18 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:GARCIA, KARINAFACILITY NUMBER:
444410976
ADMINISTRATOR/
DIRECTOR:		KARINA GARCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 761-0338
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
01/22/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:10 PM
MET WITH:Karina GarciaTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On January 22, 2025 at 12:10pm, Licensing Program Analysts (LPAs) Darnella Barnes and Marilou Monico conducted an unannounced Annual Random inspection at the residence of Karina Garcia, Licensee. The purpose of the inspection was explained. LPAs were granted access to the home by the Licensee and the Licensee received the Entrance Checklist (LIC 126).

The facility operates Monday to Friday from 6:00 a.m. to 6:00 p.m. LPAs observed required postings, including the Facility License, Notification of Parent's Rights (PUB 393), Emergency Disaster Plan (LIC610A), and Earthquake Preparedness Checklist (LIC 9148) were visible near the front entrance to the daycare. The last fire/disaster drill was documented as completed on 12/5/2025. The Licensee was reminded that fire/disaster drills must be conducted and documented every six months.

LPAs observed four children (1) 2 years old, (1) 3 years old (1) 4 years old (1) 5 years old in the home during today's inspection. Licensee was reminded of the staff-to-child ratio requirements. Supervision policies were reviewed with the licensee, who acknowledged that she must be present during daycare hours and ensure children are always supervised. Licensee was reminded that children must not stay in parked vehicles, car seats are for transport only, and reporting requirements for suspected child abuse and incidents are mandatory. Children’s rights cannot be waived, even with consent from their authorized representative.

The Licensee confirmed that licensee and her husband are the only adults residing in the home. Fingerprint clearances have been obtained and verified by LPAs on 1/17/25.

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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
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: GARCIA, KARINA
FACILITY NUMBER: 444410976
VISIT DATE: 01/22/2025
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Licensee, Karina Garcia, 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.

LPAs toured the indoor and outdoor areas of the single story home during today’s inspection. The off-limit areas of the home include attached garage, kitchen, three bedrooms, living room and dining room. The off-limit outdoor areas include left side yard and all areas outside of fenced play area for children. These areas are made inaccessible by closed doors and other barriers. LPAs advised licensee that prior to using off limits areas for daycare, licensee needs to notify Licensing and arrange for an inspection. LPAs observed a fully charged 3A-40B-C fire extinguisher that was last serviced on 1/2025, working smoke and carbon monoxide detectors, and a working telephone 831-761-0338. The home was clean, well-ventilated, and stocked with toys and playthings that are safe and age-appropriate for the children. LPA observed all poisons were locked, and hazardous items were securely stored out of reach of children. No bodies of water were observed. Licensee was reminded that smoking is not allowed, and baby walkers, bouncers, jumpers, or similar items cannot be used. And that care must be taken to keep these items inaccessible. The Licensee confirmed that no firearms or ammunition were on the premises. The Licensee was reminded to notify the department prior to any alterations or additions to the home or grounds. Licensee does 1 dog Lab that is vaccinated.

Licensee has a valid CPR/1st Aid, which expires on 1/11/2026. Licensee's Preventive Health and Safety certificate and Mandated Reporter training certificate expired 1/21/2026. LPA reminded Licensee that the Mandated Reporter training and CPR/1st Aid requires renewal every two years. Licensee has the required vaccines (MMR, Pertussis, & flu). Licensee has insurance for daycare. LPA reviewed the facility roster (LIC 9040) and three(3) children's files confirming they were complete with the required forms, including the affidavit regarding liability insurance (LIC282). LPA reminded the Licensee that an individual infant sleeping plan (LOC 9227) shall be completed for each infant up to 12 months of age and that nap check documentation should be completed until infants turn two years of age. Licensees stated that a child will be isolated from the other children in the reading area if necessary due to illness or communicable disease until a parent/guardian is able to pick them up. ------- continuation to next pages -------

SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
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: GARCIA, KARINA
FACILITY NUMBER: 444410976
VISIT DATE: 01/22/2025
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LPA discussed the safe sleep regulations with licensee, Karina Garcia, and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed 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.

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.

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.

During the exit interview, the Licensee confirmed no Registered Sex Offenders reside at the facility. The LPA completed the RSO profile in FAS on January 19, 2025. A search of the California Attorney General-Megan’s Law website found no registered sex offenders at the facility address.

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SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: GARCIA, KARINA
FACILITY NUMBER: 444410976
VISIT DATE: 01/22/2025
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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 today’s inspection, no deficiencies were found.

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

Exit interview conducted and report was reviewed with the Licensee, Karina Garcia
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Darnella Barnes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
LIC809 (FAS) - (06/04)
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