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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376612896
Report Date: 01/15/2020
Date Signed: 01/15/2020 12:23:25 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:RAMIREZ, OLGA FAMILY CHILD CAREFACILITY NUMBER:
376612896
ADMINISTRATOR:RAMIREZ, OLGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 788-1045
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY:14CENSUS: 6DATE:
01/15/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Olga Ramirez, LicenseeTIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA) Michelle Hood, made an unannounced visit to follow up on a self reported incident that occurred on 1/09/2020, wherein a child woke up from a nap, not using left arm normally. Child was diagnosed with nurse maid elbow. LPA meet with Licensee.

LPA examined the area where incident occurred. On day of incident there were eight (8) children in care and two (2) staff members. Since incident staff members monitor the sleeping position of children. If staff observe children sleeping on their arms, staff reposition the child's arm. No prior incidents have occurred in this area.

It appears this is an isolated incident. Supervision was in place, ratios were met and staff responded appropriately. The facility reported timely. The child returned back to facility on 01/10/2020.

LPA discussed Safe Sleep with licensee.

No deficiencies are cited. Provided Notice of Site Visit (LIC 9213). Exit interview conducted. LPA observed licensee post LIC 9213.
SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020
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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