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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376615877
Report Date: 08/06/2019
Date Signed: 08/06/2019 11:33:06 AM

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:ROJAS, MARYANNE FAMILY CHILD CAREFACILITY NUMBER:
376615877
ADMINISTRATOR:ROJAS, MARYANNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 690-6709
CITY:SAN DIEGOSTATE: CAZIP CODE:
92173
CAPACITY:14CENSUS: 11DATE:
08/06/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Maryanne RojasTIME COMPLETED:
11:50 AM
NARRATIVE
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Licensing Program Analyst (LPA) Yolanda Baez, made an unannounced visit for the purpose of a annual inspection. LPA met with Licensee, Maryanne Rojas. During this visit there were 11 children in care. Helper, Sharon Alvarado, was also present at the time of the inspection.

LPA toured the home, this is a one story, 4 bedrooms and 2 bathrooms home. The primary child care areas are the following: dining room area, Bathroom #1, living room, and the day care room (adjacent to the kitchen), and the back yard. The following areas are kept inaccessible with the use of locks or safety gates: all 4 bedrooms and bathroom #2, and the attached garage. There are a sufficient amount of age appropriate toys, games, and books available. The home has plenty of space for the children to eat, sleep and play, and was a comfortable temperature during this visit. The back yard is fully fenced and used for outdoor activities. The fire extinguisher is full, of regulation size, and located near the kitchen. There is a fireplace on the property and it is properly kept off limits. The smoke alarm and carbon monoxide monitor are operational. LPA Baez verified a working telephone, working email address, and all required forms are posted. There are no large bodies of water on the property. Licensee stated that there are no firearms or ammunition on the property. LPA Baez verified that all adults living or working in the home have been fingerprint cleared and associated. LPA Baez reviewed children's files, child care roster, and emergency drill log. The last emergency drill was conducted on 06/2019. Licensee's pediatric CPR/FA certification expired on 07/31/2019, see 809D for cited deficiency. LPA Baez reviewed physical plant, bodies of water, storage of hazardous items, Shaken Baby Syndrome, SIDS, emergency drills, and child care roster. LPA reminded Licensee that walkers, jumpers, exersaucers, and bouncers are not permitted for use in the day care. LPA gave Licensee a prohibited items worksheet and reviewed it with Licensee. IMS was discussed. Licensee is not currently providing IMS, Licensee understands that a written plan of operation must be submitted to CCL prior to enrolling a child that requires. 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 http://www.ada.gov/childqanda.htm

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda BaezTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
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 3
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: ROJAS, MARYANNE FAMILY CHILD CARE
FACILITY NUMBER: 376615877
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/06/2019
Section Cited
CCR
102416(c)
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(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. Requirement not met as evidenced by Licensee's file review.
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Licensee stated that she will enroll in new CPR/FA course and send LPA proof of correction of a photo of new certificate by due date of 09/06/2019.
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Licensee's CPR/FA expired on 07/31/2019. This poses a potential risk to the health and safety of the clients in care.
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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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda BaezTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: ROJAS, MARYANNE FAMILY CHILD CARE
FACILITY NUMBER: 376615877
VISIT DATE: 08/06/2019
NARRATIVE
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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. Facility is compliant with SB792.

LPA Baez discussed the Mandated Reporter training (AB1207). LPA Baez reminded Licensee that herself and all helpers are to take the training and have the printed certificates present at the facility and available for review. Licensee could not locate certificate but was able to provide proof of registration and understands that certificates for herself and helpers must be at facility available for review.

NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS. LPA observed Licensee post notice of site visit. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov

Duty Line: (619) 767-2248, Open Monday thru Friday 8am - 5pm

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda BaezTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3