376620052-8-22-2022-51-CC-NDIZ-CHJMLL-20220822094230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376620052
Report Date: 08/22/2022
Date Signed: 08/22/2022 09:42:42 AM

Document Has Been Signed on 08/22/2022 09:42 AM - 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:	DE LA CRUZ, VALERIE FAMILY CHILD CARE		FACILITY NUMBER:	376620052
ADMINISTRATOR:	VALERIE DE LA CRUZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(858) 335-7617
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92126
CAPACITY:	14	CENSUS: 4	DATE:	08/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:32 AM
MET WITH:	Valerie De la Cruz		TIME COMPLETED:	09:55 AM

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 8/22/22 @ 8:32AM, LPA Nancy Diaz conducted an unannounced inspection. LPA met with Valerie de la Cruz, licensee. Observed present today were 4 children. A tour of the home was conducted. The following areas are accessible to children: living room, family room, kitchen, dining, hallway bathroom and back fenced yard. Facility operates Monday-Thursday 7:30AM to 4:30PM. The licensee was present in the home to ensure that all children are supervised at all times. Facility is within capacity and did not exceed the capacity specified on the license. There were no bodies of water observed within the premises. Mrs. Dela cruz stated that she does not maintain any weapons in the home. Detergents, cleaning compounds, medications and other items which could pose a danger to children are stored appropriately and inaccessible to children. Fire extinguisher and smoke detectors meet State Fire Marshall standards. The carbon monoxide detector present in the home meet the standards established in Chapter 8 of Part 2, Division 12. Home is kept clean and orderly with heating and ventilation for safety and comfort. Licensee provide safe toys, play equipment and materials. The home maintains a working telephone service. LPA discussed the safe sleep regulations with licensee, Valerie dela Cruz and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Valerie dela Cruz of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

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: DE LA CRUZ, VALERIE FAMILY CHILD CARE	FACILITY NUMBER: 376620052
	VISIT DATE: 08/22/2022

NARRATIVE

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Car seats are only used for transportation purposes and not used for sleeping.

The outdoor play area is fenced or supervised by the licensee. An isolation area has been designated for children who became ill during the day.

Children’s records were reviewed. Licensee maintains a copy of the emergency information card that contains all of the information specified by the regulation.

Staff records were reviewed. Staff have completed the mandated reporter training pursuant to Health & Safety Code. Licensee was made aware that the mandated reporter training shall be renewed every 2 years.
Staff have been immunized against influenza, pertussis and measles. Licensee’s CPR and First aid is valid thru February 2024.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

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: DE LA CRUZ, VALERIE FAMILY CHILD CARE	FACILITY NUMBER: 376620052
	VISIT DATE: 08/22/2022

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Exit interview was conducted and licensing report was reviewed with the licensee, Valerie dela Cruz.

A copy of the licensing report and notice of site visit were provided with the licensee. Notice of site visit was observed posted and shall remain posted for 30 days.

The following updated forms were received today: LIC 279; LIC 279B and LIC 9108.

NO DEFICIENCY CITED TODAY.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

LIC809 (FAS) - (06/04)

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