376100019-7-1-2021-51-CC-KLAE-C4HRN2-20210701130938

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100019
Report Date: 07/01/2021
Date Signed: 07/01/2021 01:09:44 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:	GUERRA, DINA FAMILY CHILD CARE		FACILITY NUMBER:	376100019
ADMINISTRATOR:	DINA GUERRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 252-2062
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY:	14	CENSUS: 7	DATE:	07/01/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Dina Guerra		TIME COMPLETED:	11:00 AM

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 7/1/21 at 9:20 AM, Licensing Program Analysts (LPA’s) Keturah Lane and Annette Sutherland conducted an unannounced annual inspection at the facility. LPAs met with Assistant Sandra Murguia Gonzales and toured the facility. There were 5 children in care with Ms. Gonzales who explained that Licensee Dina Guerra would return shortly and went to make copies. LPAs toured the facility. Licensee arrived at 9:37 AM with her own two children and provided the roster. At 9:37 AM the census was 7 children. Licensee speaks Spanish and LPA Annette Sutherland translated. The one-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Proper supervision and ratios were observed. The fire extinguisher, carbon monoxide detector/smoke detector combo meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water on the property. Licensee states that there are no weapons in the home. 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’s First Aid and CPR certifications expire in September of 2021. Helper’s First Aid and CPR certifications expire on 1/20/22 . Licensee and staff meet immunization requirements and have completed Mandated Reporter Training which expires in March of 2023. Licensee maintains emergency records for children. Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include: living room, hallway, dining room, kitchen, bathroom and bedroom #1. Off-limits areas include: bedroom #2 which includes another bathroom and are inaccessible through use of door-knob covers. The fire-place is screened and inaccessible to children. There is a working phone at the facility. The licensee has sufficient age appropriate, safe, toys and equipment available. The home has a fenced backyard and patio available for outdoor activities. (continued on LIC809-C...)

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021

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: 07/01/2021

NARRATIVE

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Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPAs and Licensee discussed California Megan's Law and LPAs provided: www.meganslaw.ca.gov. LPA Lane reviewed Covid-19 guidelines with Licensee and provided Covid-19 resources. LPA Lane directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information. LPA provided Safe Sleep log for Licensee and advised her to check children under the age of 24 months every 15 minutes when sleeping and document it on the log. Licensee was aware that LIC9227 Infant Sleeping Plan is required for children under the age of 12 months.

No deficiencies are cited.

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.

An exit interview was conducted with the Licensee. The Licensee was provided a copy of their appeal rights (LIC 9058) along with the report (LIC809) and their signature on this form acknowledges receipt of these rights. The LIC 9213 (Notice of Site visit) was posted during today's visit. Notice of Site Visit must remain posted for 30 days.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021

LIC809 (FAS) - (06/04)

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