376604047-8-30-2024-51-CC-SBAS-D8MTTC-20240830150031

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376604047
Report Date: 08/30/2024
Date Signed: 08/30/2024 03:00:38 PM

Document Has Been Signed on 08/30/2024 03:00 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	SALVADOR, SANDRA FAMILY CHILD CARE		FACILITY NUMBER:	376604047
ADMINISTRATOR:	SANDRA SALVADOR		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(858) 558-0747
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92122
CAPACITY:	14	CENSUS:	DATE:	08/30/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:09 AM
MET WITH:	Sandra Salvador		TIME COMPLETED:	03:15 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 August 30, 2024, at 1:09 PM., Licensing Program Analyst (LPA), Sherlynn Banas conducted an unannounced Annual Licensing Inspection. LPA was greeted by licensee, Sandra Salvador. LPA Banas was granted entry as she identified herself and disclosed the purpose of her visit. Licensee’s husband, Juan Chousa was also present. There were 4 daycare children and 1 helper, N.R present. Licensee stated the hours of operation are from 7:30 AM. to 5 PM. The home is one story. The licensee uses the backyard, bathroom and the playroom as the accessible area. Off limit areas are the living room, dining room, kitchen, and all 3 bedrooms. LPA tested the carbon monoxide detector and smoke detector in one (located by the hallway) which were all operational. The fire extinguisher is located in the kitchen area. All devices were functional. There are no pools/bodies of water on the premises. Licensee does not maintain any weapons or ammunition in the home. Storage for poisons, detergents, medications are stored securely and inaccessible. The last Disaster Plan was recorded on April 26, 2024. The home is kept clean and orderly with heating and ventilation for safety and comfort. The home provides safe toys, play equipment and materials. Children’s records contained emergency contact information and immunization records. All parents or representatives received a copy of the Family Childcare Home Notification of Parent’s Rights. Sandra Salvador's CPR/First Aid card will expire in April 2026. Mandated Reporter Training certificate expires in November 28, 2024. There is a working telephone and email address for the licensee.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Sherlynn Banas	TELEPHONE: (619) 629-8368
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SALVADOR, SANDRA FAMILY CHILD CARE	FACILITY NUMBER: 376604047
	VISIT DATE: 08/30/2024

NARRATIVE

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LPA discussed the safe sleep regulations with Licensee, Sandra Salvador 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.

Licensee, Sandra Salvador was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in health and Safety code section 1596.871, must obtain 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

A review of staff records indicates that all individuals requiring a caregiver background check have received criminal record and child abuse clearances or exemptions.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Sherlynn Banas	TELEPHONE: (619) 629-8368
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/30/2024 03:00 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: SALVADOR, SANDRA FAMILY CHILD CARE	FACILITY NUMBER: 376604047
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(m)(3)

Operation of A Family Child Care Home

(3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/30/2024
	Plan of Correction
1 2 3 4	Licensee, Sandra Salvador will have h eparents sign the LIC 282.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Sherlynn Banas	TELEPHONE: (619) 629-8368
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SALVADOR, SANDRA FAMILY CHILD CARE	FACILITY NUMBER: 376604047
	VISIT DATE: 08/30/2024

NARRATIVE

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Licensee, Sandra Salvador was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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/inspection-process.

During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Deficiencies cited (see 809D).

Exit interview conducted and report was reviewed with the licensee. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Sherlynn Banas	TELEPHONE: (619) 629-8368
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

LIC809 (FAS) - (06/04)

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