136609282-8-26-2022-20-CC-CAMR-CHNQ55-20220826115119

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 136609282
Report Date: 08/25/2022
Date Signed: 08/26/2022 11:52:58 AM

Document Has Been Signed on 08/26/2022 11:52 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	PEREZ, GABRIELA FAMILY CHILD CARE		FACILITY NUMBER:	136609282
ADMINISTRATOR:	PEREZ, GABRIELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 222-0961
CITY:	EL CENTRO	STATE: CA	ZIP CODE:	92243
CAPACITY:	14	CENSUS: 5	DATE:	08/25/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	GABRIELA PEREZ		TIME COMPLETED:	07:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 8/25/2022, at 2:40 PM, Licensing Program Analyst (LPA) Claudia Amador conducted an unannounced Annual Inspection and met with Gabriela Perez. LPA disclosed the purpose of the inspection and was led on a tour of the facility indoors and outdoors. This facility is a one-story, three-bedroom, two-bathroom house. The following areas are used for childcare: the living room, bedroom #1, one hallway bathroom, and the front yard. Off-limits areas include two bedrooms, the TV room, the kitchen, and the entire backyard, which are inaccessible through baby gates, locks, and doorknob covers. There is no fireplace in the facility. Hours of operation hours are Monday – Friday, 7:30 am to 5:30 pm. There were five (5) children present during the inspection, one (1) infant, two (2) preschoolers, two (2) school age, and one (1) assistant. The fire extinguisher, smoke detector, and carbon monoxide detector met the requirements. Hazardous items were inaccessible to children in care. LPA informed licensee poisons should be placed in a storage area and locked. LPA did observe medication accessible during the inspection. The storage area for poisons is locked and inaccessible through a child safety gate and double door slide lock. LPA observed toys and materials available for children’s use. The home has a fenced front yard available for outdoor activities. LPA informed the licensee to ensure children are supervised at all times during outdoor activities. The licensee stated there were no bodies of water, and LPA did not observe any bodies of water during the inspection. The licensee said there are no firearms, other weapons, or ammunition in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal records and child abuse clearances or exemptions. A review of staff records on this date indicates that the licensee and the licensee’s assistant do not have the Mandated Reporter certification. LPA reviewed children’s files. The children’s files reviewed four(4) out of the seven (7) children were missing the immunization record. 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 the 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. Pediatric CPR and First Aid certifications expire on 08/2021. The licensee is the Property Owner the LIC9149 is not required. The licensee and the assistant have the required immunization's, per file review. The facility roster is maintained an current. Disaster and fire drills are not being conducted. Required documents are posted. There is one crib or play yard for each infant who is unable to climb out of the crib or play yard. Infant Sleep Log and Individual Infant Sleeping Plan (LIC 9227) are missing for the infants in care. The incidental Medical Services (IMS) policy was discussed. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA discussed safe sleep regulations with the licensee 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 the 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 registering all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA and licensee discussed California Megan's Law, and LPA provided: www.meganslaw.ca.gov. LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov. In addition, for general questions or questions regarding licensing requirements, contact the Child Care Licensing Duty Line at (619) 767-2248. 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 about licensed facilities, visit 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. LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. 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/tion-process. Per the California Code of Regulations (Title 22, Division 12 & Chapter 3), two (2) Type A citations and three (3) Type B citations are being cited on the attached LIC 809-D. LPA Claudia Amador informed Licensee Gabriela Perez that this report dated 08/25/2022 document(s) (2) Type A citation(s) which shall be posted for 30 consecutive days as there is an immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Claudia Amador informed the Licensee, Gabriela Perez, to provide a copy of this licensing report dated 8/25/2022 that documents Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report reviewed with Licensee Gabriela Perez. The licensee was provided a copy of their appeal rights (LIC 9058 12/15), and their signature on this form acknowledges receipt of these rights.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Claudia Amador	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

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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Document Has Been Signed on 08/26/2022 11:52 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: PEREZ, GABRIELA FAMILY CHILD CARE	FACILITY NUMBER: 136609282
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102417(g)(4)(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: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. (A) Storage areas for poisons, firearms and other dangerous weapons shall be locked. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above as analyst viewed a medince bottle (ZYRTEC)on the changing table which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 08/25/2022
	Plan of Correction
1 2 3 4	The licensee removed the item immediately, placed it in a storage container and stored the container in the kitchen. The kitchen is made inaccessible through a child safety gate.

Type A

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review the licensee did not comply with the section cited above the certification expired on 08/2021 which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2022
	Plan of Correction
1 2 3 4	The licensee will enroll in EMSA, CPR, 1ST AIDE training classes and provide verification by 09/23/2022.

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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Claudia Amador	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/26/2022 11:52 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: PEREZ, GABRIELA FAMILY CHILD CARE	FACILITY NUMBER: 136609282
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above , the two (2) infants enrolled are missing the Infant Sleep Log which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/02/2022
	Plan of Correction
1 2 3 4	The licensee stated she will provide proof of the Infant Sleep Log for two (2) infants enrolled from 8/26/2022- 09/01/2022.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review the licensee did not comply with the section cited above the licensee and the assistant are missing the Mandated Reporter Training certificate which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/02/2022
	Plan of Correction
1 2 3 4	The licensee stated she will provide copies of the Mandated Reporter Trainng certificates for herself and daughter to the LPA by 09/02/22.

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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Claudia Amador	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/26/2022 11:52 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: PEREZ, GABRIELA FAMILY CHILD CARE	FACILITY NUMBER: 136609282
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(a)

Immunizations

(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review the licensee did not comply with the section cited above in four (4) out of seven (7) children are missing the immunization records which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/02/2022
	Plan of Correction
1 2 3 4	The licnsee stated she will update immunization records for the four (4) children and provide proof to the LPA by 09/02/2022.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Claudia Amador	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

LIC809 (FAS) - (06/04)

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