376100403-5-12-2020-51-CC-SSAA-BPJPK7-20200512112239

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100403
Report Date: 05/12/2020
Date Signed: 05/12/2020 11:24:20 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:	GUEVARA, MA DE LA LUZ FAMILY CHILD CARE		FACILITY NUMBER:	376100403
ADMINISTRATOR:	MA DE LA LUZ GUEVARA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 733-6611
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92124
CAPACITY:	14	CENSUS: 0	DATE:	05/12/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Ma De La Luz Guevara		TIME COMPLETED:	11:10 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 05/12/2020 at 10:00am, Licensing Program Analysts (LPA) Samantha Salunga and Annette Sutherland conducted an announced Pre-Licensing virtual inspection with Applicant, Ma De La Luz Guevara. Due to COVID-19 state of emergency, in person inspections are not allowed at this time. This inspection was completed via video conferencing (Zoom). Applicant's 4 bedroom, 2.5 bathroom home was virtually toured and inspected to ensure an environment safe for the care and supervision of children. Applicant speaks English, however her primary language is Spanish. Applicant's husband, Angel Uriel Guevara, acted as Spanish translator sporadically throughout the televisit. Applicant's two minor daughters were also present. Applicant owns the facility and has provided proof by grant deed. Applicant stated she will use the following areas for childcare: family/living room, play room, downstairs powder bath, and kitchen/dining room. Off limits areas include: entire upstairs, pantry, laundry closet, and all other downstairs closets. Stairs are barricaded via baby gate. Applicant states she will utilize backyard for outdoor activities. There are no bodies of water observed during time of visit. The fire extinguisher, smoke and carbon monoxide detector meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children through latches, locks, and/or placed up on high surfaces. Children’s toys and play equipment are available. Applicant states there are no firearms or other weapons in the home. Applicant has completed the 7 hours of preventative health, and is enrolled to complete the 8 hours course on 05/16/2020. Pediatric CPR and First Aid certifications expire on October 2020. Required documents are posted. Applicant states her and her husband are the only adults residing in the home and have been cleared for criminal record and child abuse index clearances. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18^th birthday must be fingerprinted within 30 days. See 809-C for continuation...

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Samantha Salunga	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2020

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: GUEVARA, MA DE LA LUZ FAMILY CHILD CARE	FACILITY NUMBER: 376100403
	VISIT DATE: 05/12/2020

NARRATIVE

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Applicant has met all immunization requirements per SB792. Applicant is exempt from taking the Mandated Reported Training per AB1207 due to her primary language being Spanish. Applicant states that she will comply with all regulations and laws governing family childcare homes and that she is financially secure to operate a family childcare home for children.

The new provider packet was reviewed with the applicant including information on child abuse reporting, children’s records, ratio, immunization's, adults living or working in the home, car seat law, shaken baby syndrome, SIDS and safe sleep, effects of lead poisoning, Incidental Medical Services, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care. Applicant was also reminded to keep all items that read “keep out of reach of children” physically inaccessible to children in care. All equipment that is used should be used only as intended by the manufacturer. Applicant was 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. LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov

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

***A 90-day Provisional Small Family Child Care Home (FCCH) License is granted and effective today’s date, 05/12/2020. LPA will grant Applicant a regular Small FCCH License after Applicant submits completion of the 8 Hour Preventative Health.

A copy of this report was reviewed and will be e-mailed to Applicant. Applicant was advised that acknowledgement of the receipt of this report is to be received within twenty-four hours.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Samantha Salunga	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2020

LIC809 (FAS) - (06/04)

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