136610512-8-21-2019-20-CC-YBAZ-BF9PBW-20190821111102

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 136610512
Report Date: 08/21/2019
Date Signed: 08/21/2019 11:11:12 AM

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:	GARCIA, DALILA FAMILY CHILD CARE		FACILITY NUMBER:	136610512
ADMINISTRATOR:	DALILA GARCIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 562-0692
CITY:	CALEXICO	STATE: CA	ZIP CODE:	92231
CAPACITY:	14	CENSUS: 0	DATE:	08/21/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Dalila Garcia		TIME COMPLETED:	11:25 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	Licensing Program Analyst (LPA) Yolanda Baez conducted an announced pre-licensing site inspection for a change of location with Applicant, Dalila Garcia. Purpose of the inspection is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This 4 bedroom and 3 bathroom home was toured and inspected to ensure environment is safe for the care and supervision of children. Applicant owns the home and has provided proof of occupancy by showing LPA a bill with the home address and Applicant's name on it. Applicant will use the following areas for child care: the living room, dining area, the downstairs hallway bathroom, the kitchen, and the downstairs bedroom. The following areas are made inaccessible by the use of door knobs and safety gates: the entire upstairs which includes 3 bedrooms and 2 full bathrooms, the garage, the back yard, the laundry room, and the room located past the laundry room. The back yard is properly fenced and is currently under construction to remove the trees that have thorns on them, Applicant understands that the back yard cannot be used at this time and will have to contact CCL to have an analyst come out to inspect the back yard prior to it being used. Applicant stated that she will temporarily take the children to a neighborhood park for outdoor activities, 100% supervision was advised. There is a large pool in the back yard, it is properly fenced per CCL regulations. The fire extinguisher is rated 2A 10B:C and is located in the dining area. The smoke and carbon monoxide detectors meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children through latches, locks, and are placed up on high surfaces. Children’s toys and play equipment are available. Applicant stated that there are no firearms or ammunition in the home. Applicant has completed the 8 hours of preventative health training. Pediatric CPR and First Aid certifications expire on 03/2021. Required documents are to be posted. Applicants and all adults residing in the home have been cleared for criminal record and child abuse index clearances. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18^th birthday must be fingerprinted within 30 days.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda Baez	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

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: GARCIA, DALILA FAMILY CHILD CARE	FACILITY NUMBER: 136610512
	VISIT DATE: 08/21/2019

NARRATIVE

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Immunization records per SB792 were reviewed and is in compliance. Applicants understands that all personnel who will be providing care and supervision to children must have immunization records present at the facility available for review.

Per applicant operating hours are 23 hours, Monday through Sunday. LPA Baez advised applicants that no changes should be made to the home without prior notice and/or approval from Licensing.

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

The New Provider Resource Packet is to be sent to Applicant in the mail but the following was reviewed with the Applicant: SIDS, shaken baby syndrome, insurance, child abuse reporting, children’s records packet/facility records/required postings, immunization's (per SB792 and child immunizations), unusual incident report, roster, car seat law, visual form for ratio/capacity, prohibited items handout (walkers, exersaucers, jumpers, and bouncy seats), fire/disaster drill log. Applicant was also reminded that corporal punishment and smoking are not allowed in the day care.

Duty Line: (619) 767-2248, open Monday through Friday from 8AM to 5PM.

LPA Baez, may be reached at (619) 929-5727 and email is yolanda.baez@dss.ca.gov

The fire clearance for a large license (capacity of 14 children) was granted on 08/14/19 and sent to CCL on 08/15/19. A Large Family Child Care Home will be issued effective today.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda Baez	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

LIC809 (FAS) - (06/04)

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