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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376615390
Report Date: 01/12/2023
Date Signed: 01/12/2023 04:19:01 PM


Document Has Been Signed on 01/12/2023 04:19 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:HERNANDEZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
376615390
ADMINISTRATOR:HERNANDEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 475-2348
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY:14CENSUS: 3DATE:
01/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Maria HernandezTIME COMPLETED:
04:30 PM
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On 01/12/2023 at 2:45 PM, Licensing Program Analyst (LPA), Dana Stevens conducted an unannounced Annual Required Inspection and met with licensee Maria Hernandez. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. There were 3 daycare children present at the time of the inspection, ages 8, 7, and 10 years. Licensee stated she is not currently providing care for any Infants. Licensee's daughters/assistants were also present and assisting with child care. Licensee accompanied LPA throughout the inspection of this 3 bedroom, 2 bathroom home. The following areas are used for child care: Living room, kitchen, dining area, daycare room 1, daycare room 2 and hall bathroom. Off-limits areas are all three bedrooms, they are made inaccessible with door locks. The front and back yards are used for outdoor activities, licensee stated total supervision is provided.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements.  The licensee has toys, play equipment and materials available. Licensee stated there are no weapons in the home. A review of records on this date indicates that all individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee's and assistant's First Aid and CPR certifications expire 10/2023. Licensee completed Mandated Reporter Training 08/2021. Assistant completed Mandated Reporter training 08/2021. Facility roster and children's files were reviewed and found complete.  The last fire and disaster drills were conducted and documented on 08/2022.



LPA discussed the safe sleep regulations with licensee 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.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana StevensTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


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: HERNANDEZ, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376615390
VISIT DATE: 01/12/2023
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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

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a 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 to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will 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.

No deficiencies cited.

Exit interview conducted and copy of report and appeal rights were provided to the licensee and their signature on this form acknowledges receipt of these rights.

A notice of site visit was given and must remain posted for 30 days

SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana StevensTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
LIC809 (FAS) - (06/04)
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