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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274415971
Report Date: 11/15/2024
Date Signed: 11/15/2024 02:15:16 PM

Document Has Been Signed on 11/15/2024 02:15 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:ROCHA, YESENIAFACILITY NUMBER:
274415971
ADMINISTRATOR/
DIRECTOR:		YESENIA ROCHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 256-8923
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY: 14TOTAL ENROLLED CHILDREN: 15CENSUS: 5DATE:
11/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:40 AM
MET WITH:Yesenia RochaTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Martha Jimenez-Villanueva arrived for an unannounced annual inspection to the home and called licensee to open the door. Licensee was not at home but granted permission to enter. LPA entered in the right side of the back and was greeted by the helper. Helper was present at home with five (5) daycare children: 2 infants and 3 toddlers. Five minutes later the licensee Yesenia Rocha arrived at home and LPA explained the nature’s of today visit. All required posting materials were posted. Licensee stated that days and hours of operation are Monday to Friday from 6:00AM to 6:00PM. Per licensee, the adults that reside in the home are herself, her husband and her son. Licensee stated no children in the home. The home is a private unit located in the backyard of the main house, a one story home with three (3) bedrooms and two (2) bathrooms.

A review of staff records on 11/13/2024 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. 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.

LPA obtained a copy of current children's roster. Fire/disaster drill was conducted on November 1, 2024. LPA observed a fully charged 3A40BC fire extinguisher that was serviced on 05/01/2024, functioning smoke and carbon monoxide combo detector, no fireplace, no stairs, no wall heater, no pets, no bodies of water, and fenced backyard. Licensee stated no weapons or firearms. The playground area is in the front, right side yard and backyard. The backyard area has a fenced in the middle.

LPA toured the indoor and outdoor areas of the home during today's inspection. The home is clean, orderly, including central heating and fan for ventilation for the comfort and safe for the day care children. Cleaning products, sharp objects, and other items that are dangerous to children were stored inaccessible in the top cabinet of the kitchen. LPA observed sufficient age-appropriate materials, toys, and play equipment in the home. The children's bathroom is clean, sanitary, and operable. The home has a working telephone in the home. Off limit areas 3 bedrooms, 1 bathroom and the middle-left side of the backyard.

Report Continues in 809-C page 2.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
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 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: ROCHA, YESENIA
FACILITY NUMBER: 274415971
VISIT DATE: 11/15/2024
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Report page 2.

LPA reviewed seven (7) children's files during today's inspection for the following records: Notification of Parents Rights (LIC995A), Affidavit Regarding Liability Insurance (LIC 282), Consent for Emergency Medical Treatment (LIC627), Identification and Emergency Information (LIC700), Infant Sleep Plan (LIC 9227), sleep log (for children 0-24 months), and Immunization Records. All required forms are on file.

LPA reviewed a helper's file for the following records: Employee Rights (LIC 9052), Statement Acknowledging Requirement to Report Child Abuse (LIC 9108), immunization, TB test, current Pediatric CPR/First Aid certification and required training. Licensee has immunization in measles, pertussis, and flu. Licensee and helper have current Pediatric CPR/First Aid certifications with an expiration date of February 1st, 2025, and March 1, 2026, respectively. Licensee's and helper’s Mandated Reporter Training were completed on January 18, 2023, and February 21, 2024, respectively. LPA reminded Licensee that Mandated Reporter Training must be renewed by all staff every 2 years.

Supervision of children was discussed with the Licensee, and she understands that she must be present in the home during day care hours (80% of the operating hours) and ensure that the children are supervised at all times. Licensee understands her capacity/ratio options and she understand that she cannot have more than (14) children present in the home without at least one qualified adult present. Licensee states that a child will be isolated in the living room area close to the door entrance if necessary due to illness or communicable disease. Licensee states that she transports day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

LPA discussed the safe sleep regulations with licensee 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. PA 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.
Report Continues in 809-C page 3.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
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: ROCHA, YESENIA
FACILITY NUMBER: 274415971
VISIT DATE: 11/15/2024
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Report page 3.

Licensee is not providing IMS currently. 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)/ (800) 514-0383 (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/.

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 [email protected]. 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

Licensee 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 YESENIA ROCHA confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.



No deficiencies were cited today.

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

Exit interview conducted and report was reviewed with the licensee Yesenia Rocha in Spanish.
SUPERVISORS NAME: Susy Cervantes
LICENSING EVALUATOR NAME: Martha Jimenez-Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
LIC809 (FAS) - (06/04)
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