136610586-6-6-2022-20-CC-GGOZ-CF5PWP-20220606114100

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 136610586
Report Date: 06/06/2022
Date Signed: 06/06/2022 11:41:05 AM

Document Has Been Signed on 06/06/2022 11:41 AM - It Cannot Be Edited

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:	MARTINEZ, ELSA FAMILY CHILD CARE		FACILITY NUMBER:	136610586
ADMINISTRATOR:	ELSA MARTINEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(442) 599-0580
CITY:	CALEXICO	STATE: CA	ZIP CODE:	92231
CAPACITY:	14	CENSUS: 0	DATE:	06/06/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Elsa Martinez		TIME COMPLETED:	12:00 PM

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 June 6, 2021 at 10:00 AM, Licensing Program Analyst (LPA) Gloria Gonzalez conducted an announced prelicensing inspection with applicant, Elsa Martinez for the purpose of a change of location. LPA disclosed the purpose of the inspection and was granted a tour into the facility by the Applicant. 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 two story, 4 bedrooms, 3 bath home was toured and inspected. The hours of operation are Monday through Friday, 7:00 a.m. to 6:00 p.m. Applicant will use the following areas for child care: day care area (second living room), bathroom #3, kitchen, bedroom #4, and backyard. Off limits areas include: Entire upstairs (bedrooms #1, #2, #3, bathroom #1 and #2), laundry room, and garage. They are made inaccessible to day care children through the use of door locks, doorknob covers, and a safety gate. Applicant will utilize the backyard for outdoor activities. The upstairs is not used and 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 fireplace is screened. LPA did not observe any bodies of water during time of inspection. The fire extinguisher is rated 2A 10B:C and is located in the kitchen. Smoke and carbon monoxide detectors meet requirements and are operational. Applicant states poisons, detergents, cleaning compounds, and medicines are inaccessible to children in care and are located in off limit areas with cupboard latches and/or door locks and secured out of reach of children. Children’s toys and play equipment are available. The applicant has a working telephone/cell phone. Applicant indicated there are no firearms or other weapons in the home.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria Gonzalez	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2022

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: MARTINEZ, ELSA FAMILY CHILD CARE	FACILITY NUMBER: 136610586
	VISIT DATE: 06/06/2022

NARRATIVE

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Applicant maintains documentation of proof of control of property for review by the Department. Applicant has completed the Mandated Reporter AB1207 training certification on 3/28/22. Applicant has completed the Preventative Health Training. Pediatric CPR and First Aid certifications expire on 3/2024. Applicant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. LPA advised that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. Applicant states they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes.

Applicant was advised if there is to be an infant in care, there must be one crib or 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 shall physically check on sleeping infants up to 24 months of age every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is or shall be maintained for each infant up to 12 months of age. Licensee places infants up to 12 months of age on their backs for sleeping. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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. “And document your 809 - 809D if there are any deficiencies.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria Gonzalez	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2022

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: MARTINEZ, ELSA FAMILY CHILD CARE	FACILITY NUMBER: 136610586
	VISIT DATE: 06/06/2022

NARRATIVE

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The New Provider Resource Packet was reviewed with the applicant including information on the following: Safe Sleep, Lead Exposure, SIDS, shaken baby, child abuse reporting, community resources, children’s records, facility records, required postings, immunizations, unusual incident report, facility roster, car seat law, visual for ratio/capacity, fire/disaster drill log and discussed California Megan's Law and LPA provided the following: www.meganslaw.ca.gov. Applicant was also informed the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). LPA conducted technical support to provide applicant information regarding the COVID-19 disease. Corporal punishment and smoking are not allowed in the day care.

Please visit the Guardian web page and set-up your Guardian account. https://cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian. If you have any questions regarding Guardian, please contact CDSS at email: guardian@dss.ca.gov.

LPA discussed the maximum capacity for a large family child care home: (When there is an assistant present): 12 no more than 4 infants. Capacity 14 - no more than 3 infants. 1 child in kindergarten or elementary school and 1 child at least age 6.

Applicant is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. Duty Line was provided: (619) 767-2248.

Southern California Child Care Advocate information was provided and applicant was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

A Regular Large Family Child Care Home license maybe issued upon final file review. LPA Gloria Gonzalez interpreted and explained inspection report to applicant, applicant stated she understood.

LPA interpreted and explained the inspection report to licensee, licensee stated she understood. An exit interview was conducted with the applicant, Elsa Martinez. The applicant was provided a copy of their appeal rights (LIC 9058 12/15).

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria Gonzalez	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2022

LIC809 (FAS) - (06/04)

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