GOMEZ, ALEJANDRA

Based on record review, the licensee did not comply with the section cited above. LPA observed a fire and disaster drill log was last completed on 09/06/2023 which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee conducted a fire and disaster drill during visit. Deficiency cleared today.

Based on observation and record review, the licensee did not comply with the section cited above, Licensee has not started a safe sleep log for C1 and C2, which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will submit a safe sleep log and a written statement stating she understands the requirements of the safe sleep regulations by close of business 09/15/2022.

Based on observation and record review, the licensee did not comply with the section cited above, licensee tenant, Maria Wang, has not obtained criminal record clearance or exemption as of 09/14/2022,, which poses an immediate health, safety or personal rights risk to persons in care.,

Resolution: Licensee shall immediately deny access to the converted garage and obtain a criminal record clearance or exemption for Maria Wang, meanwhile she cannot be present in the premises or work until a criminal background or exemption is obtained. .LPA discussed the requirements of AB 633 with licensee Alejandra Gomez and provided her the AB 633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) LPA explained the use and purpose of the form LIC9224

Based on record review, the licensee did not comply with the section cited above, Licensee tenant, Maria Wang is missing LIC 508 Criminal Record Clearance, which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will obtain a completed Criminal Record Statement LIC 508 from tenant Maria and will submit a copy to the San Jose Regional Office by close of business 09/30/2022.

Based on observation and interview, the licensee did not comply with the section cited above, licensee did not notify the San Jose Regional Office of alterations in the child care home, off limit garage was converted as separate living quarters, which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee will submit a updated facility sketch to the San Jose Regional Office by the close of business 09/30/2022.

Based on observation and record review, the licensee did not comply with the section cited above, licensees C1 file is missing LIC 9227, which poses/posed a potential health, safety or personal rights risk to persons in care.

Resolution: Licensee obtained completed LIC 9227 form filled and signed by C1 parent on 09/14/2022.