376618281-8-10-2022-20-CC-LGAO-CH6ULA-20220810154026

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376618281
Report Date: 08/10/2022
Date Signed: 08/10/2022 03:40:33 PM

Document Has Been Signed on 08/10/2022 03:40 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:	PEREZ, LETICIA FAMILY CHILD CARE		FACILITY NUMBER:	376618281
ADMINISTRATOR:	LETICIA PEREZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 358-3635
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY:	14	CENSUS: 3	DATE:	08/10/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Leticia Perez		TIME COMPLETED:	03:45 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	On August 10, 2022, at 1:15PM, Licensing Program Analyst (LPA), Luigi Gargaro, conducted an unannounced annual required inspection and met with the licensee, Leticia Perez. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Three (3) children and one (1) staff, Ms. Perez herself were present in the facility during this inspection. This facility is a one floor, three bedroom, two bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas used for child care are: the kitchen/dining area, the daycare/family room and the day care bathroom. The living room in the front of the home is primarily used as a pass through area but analyst inspected it and found it to be safely child proofed and allowable for use at the licensee's discretion. Off limits areas are: the three bedrooms and inclusive master bath which are inaccessible through use of door locks and the garage is off limits with a sliding, latching entrance door in the home and a back entrance in the play yard that has a door lock. The fire extinguisher and combination smoke and carbon monoxide detector met requirements. All hazardous items were inaccessible to children. The licensee has toys, play equipment and materials available. The home has a fenced backyard available for outdoor activities. The yard contains a storage shed which is made off limits with the use of a padlock and an off limits side alleyway which is made that way with an installed gate. No bodies of water observed on the premises during the inspection. Licensee stated there are no weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee’s First Aid and CPR certifications expire in December of 2022. Licensee has required immunizations. Licensee completed Mandated Reporter Training on 08/04/21 with provider UDW. Licensee states she will take the CCL approved training at www.mandatedreporterca.com or with YMCA to meet CCL approved trainer requirement. Facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 07/22/22 and 07/18/22, respectively.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022

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: PEREZ, LETICIA FAMILY CHILD CARE	FACILITY NUMBER: 376618281
	VISIT DATE: 08/10/2022

NARRATIVE

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There is one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. The provider physically checks on sleeping infants every 15 minutes. Licensee is aware that an Individual Infant Sleeping Plan [LIC 9227 (3/20)] is to be maintained for each infant up to 12 months of age but has no children of that age currently enrolled in her day care. The provider places infants up to 12 months of age on their backs for sleeping.

LPA provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. Licensee was also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248. Unusual Incident Reports may be e-mailed to: SDIncidentReports@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.

No deficiencies cited

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

LPA provided notice of site visit and observed it being posted at the facility.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 08/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022

LIC809 (FAS) - (06/04)

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