<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376615406
Report Date: 07/01/2019
Date Signed: 07/01/2019 03:01:09 PM

COMPREHENSIVE INSPECTION
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:TISCARENO, MARIA FAMILY CHILD CAREFACILITY NUMBER:
376615406
ADMINISTRATOR:TISCARENO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 461-4756
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:14CENSUS: 5DATE:
07/01/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Maria TiscarenoTIME 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
Licensing Program Analysts (LPA), Samantha Salunga and Keturah Lane, made an unannounced Annual Random inspection and met with Licensee, Maria Tiscareno. There were 5 children in care. Also present was Licensee's helper, Yesenia Garcia. Facility was observed operating within ratio and capacity. LPA's conducted a tour of the home inside and outside per facility sketch. Licensee is using the following areas for day care: living room, day care room, and hallway bathroom. Off limit areas include: all bedrooms, kitchen and detached garage. Outside play area is completely fenced. Business Hours: 24/7.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Children’s toys and play equipment are available and observed free of hazards. There is a working telephone/email address. All cleaning compounds, detergents, medications, and poisons are made inaccessible through latches, locks, and/or placed up on high surfaces. Fireplace is screened. Fire extinguisher, carbon monoxide detector and smoke detector are operational. Licensee states there are no firearms or other weapons in the home. There is an in-ground pool in the backyard where the children play. The pool has a chain link fence that surrounds majority of the pool which has mesh material attached to it making the bodies of water visual from the other side of the fence. LPA's observed the mesh material to be in bad condition. The mesh material was observed to be ripped from various sides of the fencing making it climbable. Fencing also had a gate that swung away from the pool, however did not self-latch at all distances. An immediate $500 civil penalty was issued. Children records were reviewed for Emergency Information. There are no new adults living or working in the home over the age of 18 years. All adult residents and helpers have submitted or been cleared for criminal record and child abuse index clearances or exemptions. Pediatric CPR and First-Aid certificates are valid through 02/18/2020.

LPA's reviewed the following with Licensee: Safe Sleep Regulation Concept Handout, Car Seat Law, reporting requirements, regulation highlights, community resources, capacity limitations, supervision, clearances, emergency drills, mandated reporting, SIDS, and Shaken Baby Syndrome.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
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 6
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: TISCARENO, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376615406
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/01/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/03/2019
Section Cited
CCR
102417(g)(5)
1
2
3
4
5
6
7
Operation of a Family Child Care Home. Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.
1
2
3
4
5
6
7
Licensee states that she will purchase and install new mesh material to be attached to the chain link fencing surrounding the pool. Licensee states she will have the self-latching gate fixed so that it self-latches at all distances. Licensee states she will provide LPA Salunga with proof of correction via sending photos through email.
8
9
10
11
12
13
14
During time of inspection, LPA's observed the mesh material that is surrounding the pool fence to be in bad condition. Mesh fencing was observed ripped apart, making the chain link fencing climbable. Self-latching gate was not able to self-latch at all distances. This poses an Immediate Health and Safety risk to the clients in care. Immediate civil penalty of $500 was issued.
8
9
10
11
12
13
14
In the meantime, Licensee states she will provide direct visual supervision of the children during outdoor play. LPA's obtained a written declaration from Licensee stating the above.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: TISCARENO, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376615406
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/01/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/12/2019
Section Cited
HSC
1596.8662
1
2
3
4
5
6
7
Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility;
1
2
3
4
5
6
7
Licensee states she and any helpers that she has will take the training per AB1207 on www.mandatedreporterca.com and submit proof of certificate to LPA by POC due date.
8
9
10
11
12
13
14
proof of completion. This was not met as evidenced by; Licensee states she is unaware of AB1207 and has not taken the mandated reporter training per AB1207. This poses a Potential Health and Safety risk to the clients in care.

8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: TISCARENO, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376615406
VISIT DATE: 07/01/2019
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
26
27
28
29
30
31
32
 Licensee is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during day care operation. Licensee is aware that interference with a child’s daily functions, physical and mental abuse is not allowed. Licensee is reminded to make anything that reads, "Keep Out of Reach of Children" inaccessible to children.

Licensee failed to provide LPA's with the mandated reporter training certificate per AB1207. Immunization law (SB792) was discussed with Licensee. Licensee understands that anyone who provides care and supervision to the children must have immunization records maintained at the facility for: pertussis, measles, and influenza.

Licensee 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's discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov

Southern California Child Care Advocate information was provided and Licensee was encouraged to contact the advocate in order to be placed on an email list for updated regulation information. Advocate information was provided: Jane Cong-Huyen at 714-703-2800 or childcareadvocatesprogram@dss.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

See LIC809D for cited deficiencies. The licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed Licensee post notice of site visit.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: TISCARENO, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376615406
VISIT DATE: 07/01/2019
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
26
27
28
29
30
31
32
Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of the Fact Sheet - AB 633 Child Care Parent Notification Requirements and a copy of LIC 9224 was given to licensee.

LPA's reviewed this report with Licensee prior to obtaining her signature.

Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov.

Duty Officer: (619) 767- 2248, Monday thru Friday 8am-5pm.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
LIC809 (FAS) - (06/04)
Page: 6 of 6
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: TISCARENO, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376615406
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/01/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/01/2019
Section Cited
CCR
102417(g)(8)
1
2
3
4
5
6
7
Operation of a Family Child Care Home. All homes shall have a current roster of the children. Facility failed to maintain a current roster of the children in care. This poses a Potential Health and Safety risk to the clients in care.

1
2
3
4
5
6
7
LPA's provided Licensee with a copy of LIC9040 which Licensee completed and updated during time of inspection. LPA's obtained a copy of updated children's roster at conclusion of visit. Deficiency is cleared.
Type B
07/05/2019
Section Cited
CCR
102417(g)(9)(A)(1)
1
2
3
4
5
6
7
Operation of a Family Child Care Home. The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home. Licensee failed to document the last fire drill. Last fire drill that was documented was on 10/17/2018. This poses a Potential Health and Safety risk to the clients in care.
1
2
3
4
5
6
7
Licensee states that she will conduct and document a fire drill with the day care children and will provide LPA Salunga with a copy of the fire drill log by POC due date.
Type B
07/31/2019
Section Cited
HSC
1597.622(a)(1)
1
2
3
4
5
6
7
Employee and Volunteer Immunization. Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza,
1
2
3
4
5
6
7
Licensee states that she will provide proof of immunization records per SB792 for all personnel that provide care and supervision to the day care children to LPA Salunga by POC due date.
8
9
10
11
12
13
14
pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. Licensee failed to provide LPA's with immunization records per SB792. This poses a Potential Health and Safety risk to the clients in care.
8
9
10
11
12
13
14
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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2019
LIC809 (FAS) - (06/04)
Page: 3 of 6