376619249-11-13-2019-20-CC-JARL-BHVSUY-20191113131155

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376619249
Report Date: 11/13/2019
Date Signed: 11/13/2019 01:12:02 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:	FERNANDEZ, LIZETT FAMILY CHILD CARE		FACILITY NUMBER:	376619249
ADMINISTRATOR:	LIZETT FERNANDEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 934-9885
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91915
CAPACITY:	14	CENSUS: 5	DATE:	11/13/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Lizett Fernandez		TIME COMPLETED:	01:15 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 Analyst (LPA) Jo Ann Legaspi conducted an unannounced inspection with the Licensee. The home was toured and inspected to ensure a safe environment for the care and supervision of children. Present in the home was the Licensee and five (5) daycare children. Although daycare operational hours are subject to families’ needs, the regular schedule is 9:00 AM to 3:00 PM, weekdays. The daycare has three (3) bedrooms and three (3) bathrooms. It is a single family home with two (2) stories. The off limits areas are the second floor and the kitchen; both are barricaded with child safety gates. The following rooms are used for care: living room, dining room and one bathroom. Licensee has provided adequate space for the children to eat, sleep and play within the home. The Licensee has sufficient toys and available equipment. All equipment that is used should be used only as intended by the manufacturer. Outdoor activities are conducted on the fenced backyard. The Licensee acknowledged continuous, visual supervision is to be given to children whenever engaged in outdoor activities. The Licensee does not provide transportation for children. The fire extinguisher, carbon monoxide and smoke detector satisfy requirements and are operational. The last safety drill was on 09/19/2019. Hazardous items were secured inaccessible to children. There are no bodies of water in the home. There are no weapons in the home, per the Licensee. A review of staff records indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aide and CPR certifications expire in September 2020. Reviewed children records were observed to be complete. The child roster was observed.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 11/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019

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: FERNANDEZ, LIZETT FAMILY CHILD CARE	FACILITY NUMBER: 376619249
	VISIT DATE: 11/13/2019

NARRATIVE

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The Licensee does not dispense specialized medication or specialized medical care to children. The 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 Community Care Licensing. 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.

The provider was reminded of the following: report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care.

Based on today's visit, no deficiencies were observed and the facility was within substantial compliance.

LPA provided the Licensee with the Notice of Site Visit – LIC 9213, which is to be posted for thirty (30) days. An exit interview was conducted with the Licensee, who was provided a copy of their Licensee Rights (LIC 9058 1/16). Their signature on this form acknowledges receipt of these rights.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 11/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019

LIC809 (FAS) - (06/04)

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