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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610539
Report Date: 09/09/2021
Date Signed: 09/09/2021 07:39:51 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:CRUZ, LETICIA FAMILY CHILD CAREFACILITY NUMBER:
136610539
ADMINISTRATOR:LETICIA CRUZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 562-6164
CITY:CALEXICOSTATE: CAZIP CODE:
92231
CAPACITY:14CENSUS: 17DATE:
09/09/2021
TYPE OF VISIT:Required - 1 YearANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Leticia CruzTIME COMPLETED:
08:15 PM
NARRATIVE
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On September 9, 2021, at 3:30 p.m., Licensing Program Analyst (LPA), Gloria Gonzalez conducted an unannounced Annual Required Inspection and was met with Rosela Quinones and Licensee, Leticia Cruz arrived on or about 4:10.  LPA disclosed the purpose of the inspection and was granted entry into the facility by staff, Aracely Camarena which arrived on or about 3:38 pm.  Seventeen (17) children (4 of which were infants) and one (1) staff were present at the beginning of the inspection and one (1) staff and licensee arrived at a later time at the facility during this inspection.  This two story, four bedroom, 3 bath home was toured and inspected. The hours of operation are Monday through Saturday, 2:00 a.m. to 10:30 p.m.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements.  Hazardous items were made inaccessible to children during the inspection. The licensee has toys, play equipment and materials available. The home has a fenced backyard available for outdoor activities. The upstairs is off limits (there were four daycare children upstairs, and Licensee states one of which was one of her sons and the upstairs is gated off at the bottom of the stairway and the applicant understands the gate must be in place when children under five years are present during day care hours. The pool, is not made inaccessible to children, the pool has a fence that surrounds the pool. The pool has two gates one of the gates self-latches, self closes and the other does not self-latch and does not self-close as required by regulation and does not meet Title 22 requirements. Licensee stated there are no weapons in the home. A review of staff records on this date indicates that not all facility staff or other individuals who require caregiver background checks have not received criminal record and child abuse clearances. Adult #1 does not have a criminal background clearance, immunizations, First Aid and CPR, and TB clearance. Licensee’s First Aid and CPR certifications expire on 8/2022.  Licensee has required immunizations.  Licensee completed Mandated Reporter Training on 8/26/20.  Facility roster is maintained and was reviewed.  The last fire and disaster drills were conducted and documented on 5/25/21. There is one play yard for each infant who is unable to climb out of the crib or play yard.  Cribs or play yards are free from all loose articles and objects. Licensee physically checks on sleeping infants up to 24 months of age every 15 minutes.  An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age.  Licensee places infants up to 12 months of age on their backs for sleeping.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021
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 7
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: CRUZ, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 136610539
VISIT DATE: 09/09/2021
NARRATIVE
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LPA 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.  Licensee was also provided information regarding Safe Sleep Regulation Section 102425, SIDS, Lead exposure and Shaken Baby Syndrome.  LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.  LPA advised if there is an unusual incident to report to call Licensing and to follow up with an LIC624B within 7 days.

Duty Line at (619) 767-2248. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions, questions regarding licensing requirements, or Unusual Incident Reports LIC 624B, contact the Child Care Licensing:

Incidental Medical services (IMS) policy was discussed.  Licensee states IMS services are not being provided at this time. 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.

Deficiencies are being cited based on LPA observations and records review in accordance with the California Code of regulations, Title 22 and Health and Safety Codes violations regarding the Licensee had an unfingerprinted adult in the facility, the pool gate does not self-close and is not self-latching, LPA observed facility out of ratio, Adult #1 was alone with 17 children, LPA observed daycare children in off limit area, Adult #1 does not have First Aid and CPR, Immunizations, and TB clearance, see LIC809D.  Plans of Corrections were reviewed and developed with the Licensee. 
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021
LIC809 (FAS) - (06/04)
Page: 2 of 7
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: CRUZ, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 136610539
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/10/2021
Section Cited

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102370(d)(1) Criminal Record Clearance. All individuals subject to a criminal record review as specified in Section 1596.871 prior to working, residing or volunteering in a licensed home, ...a California clearance or a criminal record exemption as required by the Department.This requirement was not met as evidenced by:

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Based on LPA's observation and records review, Adult #1 was alone supervising 17 children. Licensee did not ensure that Adult #1 has a criminal record clearance and has been working at the facility since 9/6/21, which poses an immediate Health and Safety risk to the children in care.
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LPA reviewed the fingerprint clearance procedure. Licensee stated she understands the procedure.
Type A
09/13/2021
Section Cited

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102416.5(e) Staffing Ratio and Capacity. If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement was not met as evidenced by:
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Based on LPA's observation Adult #1 was alone supervising 17 children. Licensee did not ensure proper staffing and capacity, which poses an immediate Health and Safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: CRUZ, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 136610539
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/15/2021
Section Cited

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102417(g)(5)(A) Operation of a Family Child Care Home. All licensees shall ensure the inaccessibility of pools.....gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate…This requirement was not met as evidenced by:
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Based on observation, LPA observed the pool gate does not self-close or self-latch, the licensee did not ensure the pool gate self-latches or self-closes which poses an immediate Health and Safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: CRUZ, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 136610539
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/15/2021
Section Cited

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102416.3(a)(6) Alterations to Existing Buildings or Grounds: Prior to making alterations...licensee shall notify the Department of the proposed changed... identified as "off limits" to an area where care and supervision will be provided ...This requirement was not met as evidenced by:
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Based on observation and interviews LPA observed 4 daycare children in off limit areas upstairs. The licensee did not ensure that children in care were supervised in off limit areas.
Which poses a potential Health and Safety risk to children in care.
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Type B
09/15/2021
Section Cited

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Staff Immunizations: HSC 1597.622(a)(1)
Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination.... This requirement was not met as evidenced by:

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Based on interview and record review, immunization verification (Measles, Pertusis, Flu) for Adult #1 was unavailable for review during the inspection, which poses a potential risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: CRUZ, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 136610539
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/15/2021
Section Cited

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First Aid/CPR: CCR 102416 (c ) Personnel requirements. The licensee and other personnel as specified shall complete training ....... including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement was not met as evidenced by:
 
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Based on interview and record review, the Licensee did not ensure to maintain current pediatric CPR and first aid training for Adult #1, which poses a potential risk to the health and safety of children in care.
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Type B
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Section Cited

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102369(b)(9)The applicant shall provide...submission of the application:Evidence of a current tuberculosis clearance... prior to...initial presence in the home, for any adult in the home during the time that children are under care. This requirement was not met as evidenced by:
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Based on interviews and record review, the Licensee did not ensure to maintain proof of TB negative test for Adult #1, which poses a potential risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2021
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: CRUZ, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 136610539
VISIT DATE: 09/09/2021
NARRATIVE
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Civil Penalty was assessed in the amount of $1500, see LIC421's.

Upon Receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

An exit interview was conducted with the licensee.  The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and a copy of the Acknoledgment of Recieipt of Licensing Forms, (LIC 9224) and their signature on this form acknowledges receipt of these rights. 

LPA provided notice of site visit and observed it being posted at the facility.

An exit interview was conducted with the licensee.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021
LIC809 (FAS) - (06/04)
Page: 7 of 7