136609366-3-3-2020-20-CC-GGOZ-BMD5ES-20200303185400

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 136609366
Report Date: 03/03/2020
Date Signed: 03/03/2020 06:54:07 PM

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:	AYON, CELIA & NAVA, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	136609366
ADMINISTRATOR:	AYON, CELIA & NAVA, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 768-5161
CITY:	CALEXICO	STATE: CA	ZIP CODE:	92231
CAPACITY:	14	CENSUS:	DATE:	03/03/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	04:30 PM
MET WITH:	Maria Ayon		TIME COMPLETED:	06:53 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 March 3, 2020, at 4:30 p.m., Licensing Program Analyst’s (LPA’s), Gloria Gonzalez and Michelle Palacio conducted an unannounced Required - 1 Year Inspection and met with the Maria Nava. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Five (5) children and the two Licensees were present in the facility during this inspection. This facility is a one story, 2 bedroom, 3 bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas used for childcare are: living room, kitchen, dining room, bathroom 1. off limits areas are bedroom 1, 2, and are inaccessible through use of chain locks. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. All hazardous items were inaccessible to children. The licensee has toys, play equipment and materials available. The home has a fenced backyard available for outdoor activities. There are no bodies of water. Licensee stated there are no weapons 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 record and child abuse clearances. Licensee’s First Aid and CPR certifications expire on 4/2021. Licensee has required immunizations. Licensee completed Mandated Reporter Training. 3 of 5 children’s records were reviewed and contain immunization documentation and Notification of Parent’s Rights form.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria Gonzalez	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: AYON, CELIA & NAVA, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 136609366
	VISIT DATE: 03/03/2020

NARRATIVE

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LPA provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. Licensee was also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. 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.

Incidental Medical services (IMS) policy was discussed. Licensee states she will send in the IMS plan for future use. 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 (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: http://www.ada.gov/childqanda.htm.

No deficiencies cited.

An exit interview was conducted with the licensee. 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: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria Gonzalez	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

LIC809 (FAS) - (06/04)

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