376622613-8-14-2019-20-CC-MHOD-BF2RE8-20190814125708

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376622613
Report Date: 08/14/2019
Date Signed: 08/14/2019 12:57:14 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:	ALVAREZ, MONICA FAMILY CHILD CARE		FACILITY NUMBER:	376622613
ADMINISTRATOR:	MONICA ALVAREZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 392-2114
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92154
CAPACITY:	14	CENSUS: 3	DATE:	08/14/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Monica Alvarez, Licensee		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 Analysts (LPA's) Michelle Hood and Tresha Souza, made an unannounced annual/random inspection. Upon arrival LPA met with license and proceeded to tour the facility. During this inspection there were three (3) children in care. The facility is within licensed capacity/ratio limitations. Licensee stated there are no new adults living in the home over the age of 18 years. A review of staff records on 08/14/2019, indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. Licensee has CPR/first aid certifications valid through 10/2019. The last fire and disaster drills were conducted and documented on 07/16/2019. Off limits areas are made inaccessible to day care children through the use of doorknob covers and door locks. No bodies of water were observed during time of inspection. There is a working fire extinguisher rated 3A 40B:C, smoke and carbon monoxide detector are present and operational. Fireplace located in family room is barricaded. LPA's reviewed a sample of Children’s Records, licensee maintains the Notification of Parents’ Rights and Immunization Records as required. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children through the use of cabinet latches and/or placed in off limit areas. Adequate heating and ventilation is provided for day-care children. Children’s toys, play equipment and materials are available. Licensee states there are NO firearms or weapons in the home. Licensee maintains a current facility roster of the children which LPA's obtained during time of inspection. LPA's reviewed the following with licensee: SIDS, car seat law, reporting requirements and shaken baby syndrome. Licensee reviewed facility personnel report to confirm all adult residents/helpers associated to the facility. LPA's advised licensee that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18^th birthday must be fingerprinted within 30 days. Licensee was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

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: ALVAREZ, MONICA FAMILY CHILD CARE	FACILITY NUMBER: 376622613
	VISIT DATE: 08/14/2019

NARRATIVE

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Licensee states she does not provide IMS to clients at this time. 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.html

*** New 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.

LPA's and Licensee discussed, Safe Sleep, Effects of Lead Exposure and California Megan's Law, LPA provided: www.meganslaw.ca.gov.

LPA's reviewed this report with licensee and an exit interview was conducted. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA's observed Licensee post notice of site visit. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2019

LIC809 (FAS) - (06/04)

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