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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376622797
Report Date: 05/17/2023
Date Signed: 05/17/2023 01:10:09 PM


Document Has Been Signed on 05/17/2023 01:10 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:GONZALEZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
376622797
ADMINISTRATOR:MARIA GONZALEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 746-6880
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY:14CENSUS: 7DATE:
05/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Maria GonzalezTIME COMPLETED:
01:30 PM
NARRATIVE
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On May 17th, 2023 at 11:00 AM, Licensing Program Analyst (LPA) David Miller conducted an unannounced Annual Required Inspection and met with the licensee, Maria Gonzalez. LPA disclosed the purpose of the inspection and was granted facility entry by the Licensee. The licensee, one staff, two infants under 24-months of age and five preschoolers were present during this inspection. This facility is a two (2) story, three (3) bedroom, two (2) bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas are accessible to the day care children: Living room, master bedroom and bathroom. Off limits area include; Two bedrooms, master bathroom and kitchen. Stairway to garage is blocked by metal gate. Celene Gonzalez, the licensee's daughter, provided translation from Spanish.

The fire extinguisher and smoke/carbon monoxide detector met requirements. Licensee was reminded that continuous supervision is to be given to children whenever engaged in outdoor activities. No bodies of water were observed on the premises during the inspection. Licensee stated there are no weapons in the home and LPA did not observe any firearms at the time of this inspection.

Licensee’s First Aid and CPR certifications expire on 04/28/2025. Licensee has required immunizations. Licensee stated that she has not completed the mandated reporter training. The facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 05/10/2023.

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.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: David MillerTELEPHONE: (619) 987-8901
LICENSING EVALUATOR SIGNATURE:
DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/17/2023
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: GONZALEZ, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376622797
VISIT DATE: 05/17/2023
NARRATIVE
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LPA discussed the safe sleep regulations with licensee 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 licensee 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.

LPA reminded Licensee of 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.

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.

A deficiency was observed as per California Code of Regulations, (Title 22, Division 12 & Chapter 3), and is being cited on the attached LIC 809-D. A copy of the report and appeal rights (LIC 9058) was provided to the applicant and notice of site visit (LIC9213) was given to Licensee and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the licensee Maria Gonzalez. 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
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: David MillerTELEPHONE: (619) 987-8901
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/17/2023 01:10 PM - It Cannot Be Edited

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: GONZALEZ, MARIA FAMILY CHILD CARE

FACILITY NUMBER: 376622797

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 05/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above as evidenced by not having a Safe Sleep Log in charts for agency review, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/26/2023
Plan of Correction
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The licensee stated that she will submit proof to the Agency by 05/26/2023 that she is documenting when and how children under 24-months of age are sleeping in the Safe Sleep Log and maintain this log in all charts for chidlren who are 24-months and under
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview the licensee did not comply with the section cited above as the licensee does not have an up-to-date Mandated Reporter Certificare, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/19/2023
Plan of Correction
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The licensee stated that she will complete the mandated reporter training and submit the certificate to the agency by 06/19/2023. See link below for how to enroll in the Mandated Reporter Training:
https://www.mandatedreporterca.com
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: David MillerTELEPHONE: (619) 987-8901
LICENSING EVALUATOR SIGNATURE:
DATE: 05/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/17/2023
LIC809 (FAS) - (06/04)
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