376616806-6-11-2019-20-CC-YBAZ-BD2QRW-20190611122436

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376616806
Report Date: 06/11/2019
Date Signed: 06/11/2019 12:24:44 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:	COTA, GABRIELA FAMILY CHILD CARE		FACILITY NUMBER:	376616806
ADMINISTRATOR:	GABRIELA COTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 838-8154
CITY:	SAN YSIDRO	STATE: CA	ZIP CODE:	92173
CAPACITY:	14	CENSUS: 11	DATE:	06/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Gabriela Cota		TIME COMPLETED:	12:30 PM

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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, Gabriela Cota. Also present during the inspection was Licensee's son/helper, Guillermo Cota. During this visit there were 11 children in care (2 infants and 9 toddlers).

LPA toured the home, this is a two story, 4 bedrooms and 3.5 bathrooms home. The primary child care areas are the following: dining room area, one hallway bathroom, the day care area that is adjacent to the kitchen and the back yard. The following areas are kept inaccessible with the use of locks or safety gates: 3 upstairs bedrooms, one downstairs bedroom, 2 upstairs bathrooms, 1 downstairs bathroom, 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 day care bathroom. There is no fireplace on the property. 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. Last emergency drill was conducted 04/17/19. Licensee's pediatric CPR/FA certification expires on 01/2020.

LPA Baez reviewed the following with Licensee: physical plant, bodies of water, storage of hazardous items, Shaken Baby Syndrome, SIDS, new Safe Sleep Regulations, emergency drills, child care roster, and Unusual Incident Reports. LPA reminded Licensee that walkers, jumpers, exersaucers, and bouncers are not permitted for use in the day care. Licensee was provided with the Spanish PIN 19-05-CCP.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda Baez	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2019

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: COTA, GABRIELA FAMILY CHILD CARE	FACILITY NUMBER: 376616806
	VISIT DATE: 06/11/2019

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IMS was discussed. Licensee stated that there are not any children currently enrolled who require IMS, however there is already an IMS plan of operation approved by CCL and is on file. 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

Immunization law (SB792) was discussed with Helper. Helper 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 and helper are compliant with SB792.

LPA Baez discussed the new Mandated Reporter training (AB1207) with Helper and Helper understands that herself and her helpers will need to take the training and keep the certificate present at the facility for review. Licensee and helper are compliant with AB1207.

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

There were not any deficiencies issued throughout today's inspection. 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 Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda Baez	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2019

LIC809 (FAS) - (06/04)

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