376615625-10-16-2019-51-CC-NDIZ-BGZTZ3-20191016150940

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376615625
Report Date: 10/16/2019
Date Signed: 10/16/2019 03:09:49 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:	GAITAN, MARTHA FAMILY CHILD CARE		FACILITY NUMBER:	376615625
ADMINISTRATOR:	MARTHA GAITAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(858) 320-0589
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92122
CAPACITY:	14	CENSUS: 2	DATE:	10/16/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Martha Gaitan		TIME COMPLETED:	03:00 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	An unannounced random inspection was conducted today. Upon arrival LPA observed two children in care with the licensee. One child was observed having lunch consisting of ground beef with potatoes, rice and lentils. Milk was also served today. LPA conducted a tour of the home to ensure the health and safety of children. Licensee is using the following areas for daycare: dining, living room, playroom, kitchen, hallway bathroom and outside patio/backyard. The following areas are off-limits to children: Second floor. These areas are inaccessible to children via barricade at the bottom of the stairs. The licensee is present in the home and ensures that children in care are supervised at all times. The licensee has maintained capacity specified on the license. Each child has safe, healthful and comfortable accommodations, furnishings and equipment. There is a spa present in the backyard that is inaccessible to children via fencing as specified by regulation. Mrs. Gaitan stated that she does not maintain any weapons in the home. All cleaners, toxics, and other hazardous substances are inaccessible to children in care via storage in the laundry room and in the cabinet above the kitchen counter. Fire extinguisher and smoke detectors present in the home meet State Fire Marshall standards. The home is kept clean and orderly with sufficient ventilation for safety and comfort. The home provides toys, and materials. The home maintains a working telephone service. Stairs are fenced or barricaded (where that are children less than five years old present). Facility has a cabon monoxide detector that meet the statutory requirements. The home has a current roster of the children. The home conducts fire and disaster drills at least once every six months, and documents the date and time of each drill. Licensee documents immunizations and maintains and updates records for children in care. Licensee provides the child’s parent or representative with a copy of the Family Child Care Home Notification of parents’ rights. The licensee and other personnel has completed training on Preventative Health Practices including Pediatric CPR and First aid. Licensee’s CPR & First Aid certificate are valid through November 2019. CONTINUED ON PAGE 2

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

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: GAITAN, MARTHA FAMILY CHILD CARE	FACILITY NUMBER: 376615625
	VISIT DATE: 10/16/2019

NARRATIVE

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A handout was provided to the licensee today on “Effects of Lead Exposure”. Licensee shall provide a copy of this handout to all the daycare parents.
The following handouts were provided to the licensee today:
- PIN 19-10-CCP – U.S. Consumer Product Safety Commission recall
- PIN 19-09-CCP – Head Lice Information for Child Care Providers
- Health & Human Services Agency Guidance on Head Lice Prevention and Control
- PIN 19-08-CCP – CA Department of Public Health New Pre-Kindergarten Immunization requirements
- PIN 19-06-CCP – U.S. Consumer Product Safety Commission recall
- PIN 19-02-CCP – Safe Sleep Awareness Campaign

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website. Please go to www.ccld.ca.gov and click on Child Care, go under Quick Links and Quarterly updates, click on “Receive Important Updates” then enter your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

LPA observed the Representative post the Notice of Site Visit in a prominent place. The Representative states it is understood that this notice must be posted for 30 days.

Mrs. Gaitan resides in the home with her husband, Francisco Tapia and their 3 adult children - Francisco, Emmanuel and Paloma.
There are no new adults living or working in the home over the age of 18 years. All individuals subject to criminal record review have obtained criminal record clearance or exemption prior to working, residing or volunteering.
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

NO DEFICIENCY CITED TODAY.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019

LIC809 (FAS) - (06/04)

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