136610324-4-6-2021-20-CC-ECAA-BZTVTX-20210406164351

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 136610324
Report Date: 04/06/2021
Date Signed: 04/06/2021 04:44:40 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:	GASTELUM, IVETTE FAMILY CHILD CARE		FACILITY NUMBER:	136610324
ADMINISTRATOR:	IVETTE GASTELUM		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 693-5082
CITY:	EL CENTRO	STATE: CA	ZIP CODE:	92243
CAPACITY:	14	CENSUS: 2	DATE:	04/06/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Ivette Gastelum		TIME COMPLETED:	10:32 AM

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 April 6th, 2021 at 9:50 AM, Licensing Program Analyst (LPA), Edgar Campana conducted an unannounced video-conference case management inspection via WhatsApp, due to the COVID-19 outbreak, with licensee, Ivette Gastelum. LPA notified licensee the purpose of the inspection was for approval of Bedroom 1 and front patio which were previously off limits. Present at the daycare was 1 daycare child at time of beginning of inspection. Another child arrived approximately five (5) minutes after inspection began. Licensee lead LPA on tour of the facility.Proposed room and patio were inspected and found to be fit for daycare use. Licensee will use the following areas for child care: Daycare room, kitchen, laundry room, living room, bathroom 1, bedroom 1, and front patio. Off limits areas will be bedroom 2, bathroom 2, and all of back patio. There are no bodies of water observed during time of inspection. There is a sufficient amount of age appropriate toys, games, and books available. The home was clean and orderly during inspection and COVID-19 precautions are in place. The fire extinguisher is rated 2-A;10; BC, smoke alarm and carbon monoxide detector are operational. There is a working telephone in the home and all required forms are posted. Licensee stated that there are NO firearms or ammunition on the property. Last fire/disaster drill was conducted 12/17/2020. Pediatric CPR and First Aid certification expire 02/2022. LPA discussed with Licensee maintaining supervision of day children at all times. LPA reviewed the following with licensee: SIDS, car seat law, reporting requirements, shaken baby syndrome and care and supervision. Licensee was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Edgar Campana	TELEPHONE: (619) 767-2208
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2021

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: GASTELUM, IVETTE FAMILY CHILD CARE	FACILITY NUMBER: 136610324
	VISIT DATE: 04/06/2021

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.html

The maximum capacity for a large family child care home: 12 children (with a qualified assistant) with no more than 4 infants; or (with landlord consent) 14 children (with a qualified assistant) with no more than 3 infants, 1 child enrolled in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. When there is no Qualified Assistant present, at least 14 years of age, the capacity reverts back to the requirements for a Small Family Child Care. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

A copy of the case management report, Notice of Site Visit – LIC 9213 and appeal rights (LIC 9058) will be e-mailed to the licensee and the licensee was advised that acknowledgement of receipt of the report and appeal rights are to be received within twenty-four hours. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Edgar Campana	TELEPHONE: (619) 767-2208
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2021

LIC809 (FAS) - (06/04)

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