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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610495
Report Date: 05/11/2021
Date Signed: 05/11/2021 11:31:14 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:GONZALEZ, KIMBERLY FAMILY CHILD CAREFACILITY NUMBER:
136610495
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
05/11/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Kimberly GonzalezTIME COMPLETED:
02:10 PM
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On 05/11/21 at 12:45PM, LPAs, Luigi Gargaro and Claudia Amador, conducted an unannounced capacity increase visit with the applicant. The visit was conducted as a tele-inspection via the FaceTime video application due to the ongoing COVID-19 pandemic. Present were the applicant, her minor assistant and seven day care children. The two story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. The facility has a pool that has been previously inspected and approved. During today's visit, the two self-closing and self-latching gates for the pool were inspected and operated as required.

Applicant has a firearm in the home that is made inaccessible to children in care as it is stored in a home safe with the ammunition kept in a secured, separate lock box. 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 or exemptions. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 04/23/21 from the City Of Brawley Fire Department. First Aid and CPR certifications expire on 01/20/23.

Applicant will be using the following rooms for childcare: the kitchen, the dining room, the living room, the two downstairs bedrooms and the two downstairs bathrooms. The following areas will be off limits: the laundry room, the second floor of the home and the detached garage. The laundry room is made off limits with a door knob cover that is installed on its door handle. The second floor of the home is inaccessible through use of a secured child safety gate that is installed at the at the bottom of the home staircase while the detached garage is made off limits with a locking door handle. The home office area is used as a pass through area to access the backyard and not as a main day care room but analyst reviewed it with the applicant today and found it to be safely child proofed with no hazards. Applicant also has a front patio that was inspected and may be used as an occasional activity area with direct supervision. The applicant has sufficient toys and equipment available.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: GONZALEZ, KIMBERLY FAMILY CHILD CARE
FACILITY NUMBER: 136610495
VISIT DATE: 05/11/2021
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The home has a fenced backyard available for outdoor activities with an off limits portion of the yard used used as a dog run area. The dog run area is made off limits with separate fencing and latching entrance gates. The back yard pool and detached garage are made inaccessible as previously noted.

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. LPA and licensee discussed California Megan's Law and he provided licensee with the website address: www.meganslaw.ca.gov for her to review information regarding her facility on a regular basis.

The home appears to be in sufficient compliance and as no corrections are needed, a license for 14 will be issued effective today.

A copy of the report will be e-mailed to applicant and she was advised that acknowledgement of the receipt of the report is to be received by analyst within twenty-four hours.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2021
LIC809 (FAS) - (06/04)
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