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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136609792
Report Date: 07/25/2022
Date Signed: 07/25/2022 07:41:52 PM


Document Has Been Signed on 07/25/2022 07:41 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:PREBOT, MARIA FAMILY CHILD CAREFACILITY NUMBER:
136609792
ADMINISTRATOR:MARIA PREBOTFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 768-0163
CITY:CALEXICOSTATE: CAZIP CODE:
92231
CAPACITY:14CENSUS: 2DATE:
07/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Maria PrebotTIME COMPLETED:
07:30 PM
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On July 25, 2022, at 4:15 p.m., Licensing Program Analyst (LPA), Gloria Gonzalez conducted an unannounced Annual Required Inspection and met with the Licensee, Maria Prebot.  LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee.  Two (2) daycare children and one staff were present in the facility during this inspection. This facility is a two story, 5 bedroom, 4 bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas used for child care are: living room, dining room, kitchen, bathroom #1, playroom/office, and backyard.  Off limits areas are garage, all of upstairs (3 bedrooms and 2 bathrooms), newly added (separate living area that includes 2 bedrooms and 1 bathroom) and are inaccessible through use of door locks and a safety gate. Hours of operation are: Monday to Sunday from 6:00 am to 9:00 pm.

Licensee states she has divided her home by a wall that includes 2 bedrooms and 1 bathroom not used for child care. Licensee did not advise Licensing regarding the changes made in May of 2022.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements.  Hazardous items were made inaccessible to children during the inspection. The licensee has toys, play equipment and materials available.  The home has a fenced backyard available for outdoor activities at time of inspection.  The upstairs is not used and is gated off at the bottom of the stairway and the applicant understands the gate must be in place when children under five years are present during day care hours. No bodies of water observed on the premises during the inspection. Licensee stated there are no weapons in the home.  A review of staff records on this date indicates that not all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse 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.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2022
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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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: PREBOT, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 136609792
VISIT DATE: 07/25/2022
NARRATIVE
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Licensee’s First Aid and CPR certification expires on 6/2023.  Licensee has required immunizations.  Licensee completed Mandated Reporter Training on 3/25/18 and has expired.  Facility roster is maintained and was reviewed.  The last fire and disaster drills were conducted and documented on 2/3/22.

There is one crib or play yard for each infant who is unable to climb out of the crib or play yard.  Cribs or play yards are free from all loose articles and objects. Licensee physically checks on sleeping infants up to 24 months of age every 15 minutes.  An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age.  Licensee places infants up to 12 months of age on their backs 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-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.

LPA provided and discussed the following:  Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms.  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 information regarding SIDS, Lead exposure and Shaken Baby Syndrome.  LPA and Licensee discussed California Megan's Law and LPA provided:www.meganslaw.ca.gov
LPA advised if there is an unusual incident to report to call Licensing within 24 hours and to follow up with an LIC624B within 7 days. In addition, for general questions, questions regarding licensing requirements call Child Care Licensing.

Duty Line at (619) 767-2248. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov.

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2022
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: PREBOT, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 136609792
VISIT DATE: 07/25/2022
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. 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.

Deficiencies are being cited based on LPA observation in accordance with the California Code of regulations, Title 22, violations regarding the (what regulation was not met and regulation #) see LIC809D. Plans of Corrections were reviewed and developed with the Licensee. 

LPA Gonzalez informed licensee, Maria Prebot that this report dated 7/25/22 of 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Gonzalez informed the licensee to provide a copy of this licensing report dated 7/25/22 that documents any 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. Civil Penalty was assessed in the amount of $500, see LIC421.

Failure to comply with posting requirements shall result in an immediate civil penalty of $500.

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/‌inspection-process.

A copy of the report and appeal rights (LIC 9058) was provided to the applicant and notice of site visit (LIC9213) was given to Licensee and must remain posted for 30 days.

LPA interpreted and explained the inspection report to licensee in Spanish, licensee stated she understood.

An exit interview conducted and report was reviewed with the licensee, Maria Prebot.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 07/25/2022 07:41 PM - 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: PREBOT, MARIA FAMILY CHILD CARE

FACILITY NUMBER: 136609792

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 07/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(d)(1)
Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and Licensee admission, the licensee did not comply with the section cited above in that Licensee did not ensure in having Adult #1 Criminal Record Clearance which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/27/2022
Plan of Correction
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Licensee states she will send the department a copy of a completed LIC9163 to the department by 7/27/22.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 07/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5


Document Has Been Signed on 07/25/2022 07:41 PM - 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: PREBOT, MARIA FAMILY CHILD CARE

FACILITY NUMBER: 136609792

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 07/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
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Based on record review, the licensee did not comply with the section cited above in that Licensee did not ensure in having an updated Mandated Reporter Training Certificate, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/28/2022
Plan of Correction
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Licensee states she will sumit an updated Mandated Reporter Certificate by 7/28/22.
Type B
Section Cited
CCR
102416.3(a)(2)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (2) Room additions to the family child care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in Licensee did not advise Licensing of room additions to her facility, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/28/2022
Plan of Correction
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Licensee states she will send the department an updated facility skecth and a written statement of changes made by 7/28/22.

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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 07/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2022
LIC809 (FAS) - (06/04)
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