136610513-8-21-2019-20-CC-YBAZ-BF9QKC-20190821121407

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 136610513
Report Date: 08/21/2019
Date Signed: 08/21/2019 12:14:12 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:	TIRADO, DIANA FAMILY CHILD CARE		FACILITY NUMBER:	136610513
ADMINISTRATOR:	DIANA TIRADO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 556-0168
CITY:	CALEXICO	STATE: CA	ZIP CODE:	92231
CAPACITY:	14	CENSUS: 3	DATE:	08/21/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Diana Tirado		TIME COMPLETED:	12:20 PM

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Licensing Program Analyst (LPA) Yolanda Baez conducted an announced pre-licensing site inspection for a change of location with Applicant, Diana Tirado. 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 3 bedroom and 2 bathroom home was toured and inspected to ensure environment is safe for the care and supervision of children. Applicant's 3 minor children were present during today's inspection.

Applicant rents 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 kitchen, "Room 1" (per facility sketch), the hallway bathroom, and the back yard. The following areas are made inaccessible by the use of door knobs and safety gates: Room #2, Room #3, the bathroom located inside of Room #3, the laundry room, and the garage. The garage is currently in the process of being converted by the landlord and will be rented out to someone else, Applicant understands that the other tenant will have to comply with fingerprint clearance regulations prior to residing in the residence. The back yard is properly fenced and will be used for outdoor activities. There are not any bodies of water on the property. The fire extinguisher is rated 2A 10B:C and is located in the kitchen. 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 08/2021. Required documents are 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: TIRADO, DIANA FAMILY CHILD CARE	FACILITY NUMBER: 136610513
	VISIT DATE: 08/21/2019

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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 was given and reviewed with the Applicant which includes the following information: 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

A fire clearance is pending, LPA spoke to Fire Inspector while at the inspection and he stated that an inspection was completed and he sent the STD850 to CCL on 08/16/19, LPA asked to send STD850 to her email. A Large Family Child Care Home will be issued once the STD850 is received.

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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