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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100019
Report Date: 07/02/2019
Date Signed: 07/02/2019 11:06:57 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:GUERRA, DINA FAMILY CHILD CAREFACILITY NUMBER:
376100019
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
07/02/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Dina GuerraTIME COMPLETED:
11:30 AM
NARRATIVE
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A pre-licensing inspection for a change of location was conducted by Nancy Diaz, LPA. Met with applicant, Dina Guerra. Mrs. Guerra's Pediatric First Aid/CPR certification are valid through September 2019. Mrs. Guerra and her spouse, Jose Cardenas have received criminal record and TB clearances.

This two-bedroom; one-bathroom home was inspected to ensure that it meets the Health & Safety standards as required by regulations governing Family Child Care Homes. The following areas are used for day care: living room, kitchen, bathroom, child's bedroom and back fenced yard. Master bedroom and front yard are off-limits to children. Lower cabinets in the kitchen and bathroom are latched to make toxics, detergent and other items which could pose a danger if readily available to children inaccessible. Mrs. Guerra understands that children are to be visually supervised during all outdoor activities. There is an operational smoke alarm, carbon monoxide detector and fire extinguisher maintained in the home. The home has electrical outlet covers throughout the daycare areas. There are toys, games, books and napping equipment for children's use. Mrs. Guerra stated that she does not maintain any weapons in the home. There were no bodies of water observed within the premises.

Applicant has met all immunization requirements per SB792. Applicant is reminded to make anything that reads, "Keep Out of Reach of Children" inaccessible to children.

Applicant is exempt from Mandated Reporter AB1207 training certification due to applicant having limited English proficiency, applicant’s primary language is Spanish.

Applicant states that she will comply with all regulations and laws governing family child care homes and that she is financially secure to operate a family child care home for children. LPA reviewed this report with Applicant prior to obtaining her signature.

CONTINUED ON PAGE TWO
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
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: GUERRA, DINA FAMILY CHILD CARE
FACILITY NUMBER: 376100019
VISIT DATE: 07/02/2019
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Applicant will email childcareadvocatesprogram@dss.ca.gov to request to be on the distribution list for child care updates.

Applicant does not plan on providing IMS to clients at this time. 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

Daycare Hours are: 7 DAYS/24 HOURS.

NO CORRECTION NEEDED. LICENSE IS GRANTED FOR A SMALL CHILD CARE HOME EFFECTIVE TODAY, JULY 2, 2019.

The maximum capacity for a small family child care home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home.
An exit interview was conducted.


Community Care Licensing WEB SITE: http://ccld.ca.gov
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
LIC809 (FAS) - (06/04)
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