376624415-6-2-2022-20-CC-LGAO-CEYSDU-20220601134743

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376624415
Report Date: 06/01/2022
Date Signed: 06/02/2022 09:28:05 AM

Document Has Been Signed on 06/02/2022 09:28 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:	QUEZADA, EDA FAMILY CHILD CARE		FACILITY NUMBER:	376624415
ADMINISTRATOR:	EDA QUEZADA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 501-9675
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY:	14	CENSUS: 1	DATE:	06/01/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Eda Quezada		TIME COMPLETED:	01:50 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 June 1, 2022, at 10:05 AM, Licensing Program Analyst (LPA), Luigi Gargaro, conducted an unannounced annual required inspection and met with the licensee, Eda Quezada. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. One child, the licensee's grandchild, and the licensee were present in the facility during this inspection. This facility is a two floor, five bedroom, two bathroom home. Licensee accompanied LPA inside of the facility during this inspection. The following areas used for child care are: the kitchen, the living room area and the bathroom. Off limits areas are the main floor bedroom and the entire upstairs. The main floor bedroom is inaccessible with the use of a locking door handle. The second floor of the home is made inaccessible through use of a child safety gate located at the bottom of the home staircase. The fire extinguisher, smoke detector, 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 which the licensee states still remains off limits as it stores personal items and is not accessible. Licensee understands that if she wants to use it in the future, she must first contact analyst to inspect and approve it. The backyard is made off limits with a latching, sliding door. Licensee does have a child's wading pool in her off limits back yard area and understands it must always be used with supervision and emptied after each use. Licensee stated there are no weapons in the home. A review of staff records on this date indicates that not all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee has one relative in the home who is not associated to the facility and a second who has a pending clearance. Licensee’s First Aid and CPR certifications expire on 02/05/24. Licensee does not have required immunizations on file. Licensee does not have a completed Mandated Reporter Training certification on file. Facility roster is maintained and was reviewed. Licensee has not conducted fire and disaster drills due to being closed during the pandemic. Licensee currently has one infant in care but that infant can crawl out of a playpen and naps on a cot. The provider physically checks on sleeping infants every 15 minutes.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 6

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: QUEZADA, EDA FAMILY CHILD CARE	FACILITY NUMBER: 376624415
	VISIT DATE: 06/01/2022

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
26
27
28
29
30
31
32

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.

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.

One type A and two type B violations California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 809-D.

Upon Receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

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: 06/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2022

LIC809 (FAS) - (06/04)

Page: 5 of 6

Document Has Been Signed on 06/02/2022 09:28 AM - 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: QUEZADA, EDA FAMILY CHILD CARE	FACILITY NUMBER: 376624415
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

Criminal Record Clearance


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Type A

Section Cited

CCR

102370(d)(1)

Criminal Record Clearance

(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on analyst interview and record review, the licensee did not comply with the section cited above as two adults in the home did not have criminal record clearance which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 06/01/2022
	Plan of Correction
1 2 3 4	Adult in home, Elio De La Torre, has a pending clearance while second adult, Socoro Chavez, who did submit to Livescan fingerprinting, was not associated to the facility. Analyst will discuss status of adults with manager and advise licensee of follow up steps. Licensee was cited corresponding civil penalties for the uncleared adults.

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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2022

LIC809 (FAS) - (06/04)

Page: 3 of 6

Document Has Been Signed on 06/02/2022 09:28 AM - 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: QUEZADA, EDA FAMILY CHILD CARE	FACILITY NUMBER: 376624415
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

Infant Safe Sleep


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Type B

Section Cited

CCR

102425(j)(2)(A)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: Labored breathing. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on analyst interview and record review, the licensee did not comply with the section cited above as it was found that she was not keeping a safe sleep log for the infant she has in care which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/06/2022
	Plan of Correction
1 2 3 4	Licensee was not aware of the infant safe sleep regulations but states she now understands the requirement and will keep a napping log for all infants in care. Licensee states she will maintain a log for the infant in care going forward and submit a sample copy of it to analyst from 06/01/22 to 06/03/22 to demonstrate it and complete the correction.

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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2022

LIC809 (FAS) - (06/04)

Page: 6 of 6

Document Has Been Signed on 06/02/2022 09:28 AM - 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: QUEZADA, EDA FAMILY CHILD CARE	FACILITY NUMBER: 376624415
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/01/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

Infant Safe Sleep


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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
1 2 3 4	Based on analyst interview, the licensee did not comply with the section cited above in as it was found that her previous Mandated Reporter Certification has expired and she has not renewed it which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/05/2022
	Plan of Correction
1 2 3 4	Licensee states she will complete the Mandated Reporter Training course and submit a copy of a current certificate of completion to analyst by 07/05/22 to complete the correction.

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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2022

LIC809 (FAS) - (06/04)

Page: 2 of 6