136610450-10-5-2021-20-CC-ACAN-C7HSGA-20211005135137

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 136610450
Report Date: 09/30/2021
Date Signed: 10/05/2021 01:52:08 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:	PIMENTEL, EVELYN FAMILY CHILD CARE		FACILITY NUMBER:	136610450
ADMINISTRATOR:	EVELYN CARDENAS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 545-0205
CITY:	IMPERIAL	STATE: CA	ZIP CODE:	92251
CAPACITY:	14	CENSUS: 6	DATE:	09/30/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Evelyn Pimentel		TIME COMPLETED:	09:20 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 09/30/2021, at 8:15 a.m., Licensing Program Analyst (LPA), Adrian Castellon conducted an unannounced Annual Required Inspection and met with licensee Evelyn Pimentel. LPA discussed the purpose of the inspection and was granted entry into the facility by Licensee Pimentel. There were six children present in the facility during this inspection. Also present was the licensee's cleared assistant and husband. The following areas are used for daycare purposes: entire first floor except for the laundry room which is properly secured. The second floor is off limits and properly barricaded. Licensee accompanied LPA Castellon inside and out of the facility during this inspection. A fully fenced backyard will be used for daycare purposes. The fire extinguisher, smoke detector and carbon monoxide detector meet requirements. All hazardous items were inaccessible to children. The storage area for poisons is locked. The licensee has toys, play equipment and materials available. No bodies of were water observed on the premises during the inspection. Licensee stated there are weapons in the home. LPA Castellon ensured proper storage. Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee’s First Aid and CPR certifications are valid thru 1/2022. Licensee has required immunization's. Emergency disaster drill requirement was met. Children's files reviewed on this date. LPA Castellon 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.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021

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: PIMENTEL, EVELYN FAMILY CHILD CARE	FACILITY NUMBER: 136610450
	VISIT DATE: 09/30/2021

NARRATIVE

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Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome was discussed. 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. 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. Licensee Pimentel does not provide IMS.

SAFE SLEEP PLAN and documentation was discussed. The licensee was advised to physically check on sleeping infants every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age and shall be available to the Department for review. The licensee must place infants up to 12 months of age on their backs for sleeping.

Mandated Reporter training requirement was met.

An exit interview was conducted with the licensee. The licensee will be provided a copy of this report via email. No citations issued on this date.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021

LIC809 (FAS) - (06/04)

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