370810554-6-14-2023-20-CC-VWIN-CSSW4Z-20230614165821

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 370810554
Report Date: 06/14/2023
Date Signed: 06/14/2023 04:58:33 PM

Document Has Been Signed on 06/14/2023 04:58 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	CUMPLIDO, SANDRA FAMILY CHILD CARE		FACILITY NUMBER:	370810554
ADMINISTRATOR:	SANDRA CUMPLIDO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 370-0563
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91911
CAPACITY:	14	CENSUS: 10	DATE:	06/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Sandra Cumplido		TIME COMPLETED:	05:10 PM

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On 6/14/2023, at 2:25 pm., Licensing Program Analyst (LPA), Vicky Williamson conducted an unannounced annual required Inspection. LPA met with Licensee, Sandra Cumplido. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee.. There were 10 daycare children present, three of whom are under 24 months. Also present was licensee's assistant Maria Juarez. Days and hours of operation are Monday - Friday, 6:30am- 5:00pm.

This is a 3 bedroom, 2 bath single level home. The following areas are used for childcare: living room, kitchen, dining room, daycare room 1, daycare room 2, hallway bathroom and side yard (daycare play area). Off limit areas include: three (3) bedrooms, bathroom (inside of master), backyard patio area and downhill area outside of patio. The off limits areas are made inaccessible through the use of a door knob covers, safety gates, safety latches, locks.

The fire extinguisher, smoke and carbon monoxide detectors meet requirements. Hazardous items were made inaccessible to children during the time of inspection. The licensee has toys, play equipment and materials available for children. Licensee stated that there are no bodies of water on the premises. LPA observed no bodies of water on the premises during the inspection. Licensee stated there are no weapons in the home. The last fire drill was conducted on 5/26/2023 and disaster drill was conducted on 5/23/2023.

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. Licensee 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.
See LIC 809C Continuation...

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CUMPLIDO, SANDRA FAMILY CHILD CARE	FACILITY NUMBER: 370810554
	VISIT DATE: 06/14/2023

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Mandated Reporter training and First Aid and CPR certifications for licensee and assistant are valid. Licensee and assistant have the required immunization records on file. LPA informed licensee to ensure the mandated reporter training is completed once every two years. LPA observed the required documents posted. A sample of children’s files were reviewed and determined to be complete.

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 discussed 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. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA and licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA discussed and provided Licensee with the following: childcare advocates email address: childcareadvocatesprogram@dss.ca.gov. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed - related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CUMPLIDO, SANDRA FAMILY CHILD CARE	FACILITY NUMBER: 370810554
	VISIT DATE: 06/14/2023

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/tion-process.

No deficiencies cited during today's inspection. An exit interview was conducted with Licensee, Sandra Cumplido and a copy of this report along with Appeal Rights were provided. A Notice of Site Visit was given and must remain posted for 30 days from today’s date. LPA observed Notice of Site Visit posted to bulletin board in daycare room. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

LIC809 (FAS) - (06/04)

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