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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376625406
Report Date: 06/11/2019
Date Signed: 06/11/2019 11:34:27 AM

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:GIL-CERVANTES, SANDRA FAMILY CHILD CAREFACILITY NUMBER:
376625406
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
06/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:41 AM
MET WITH:Sandra Gil-CervantesTIME COMPLETED:
11:40 AM
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 (3) Licensing Program Analyst (LPA) Selina Siao conducted an unannounced random inspection with the Licensee. The home was toured and inspected to ensure an environment safe for the care and supervision of children. Present at the facility were the Licensee and 3 preschool age day care children. The home has a fully charged fire extinguisher size 3A40BC, smoke and carbon monoxide detector that meet requirements and are operational. Hazardous items were latched/locked and secured out of reach of children. Licensee stated that the home does not have any bodies of water or weapons. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances. Licensee's First Aid and CPR certifications are current due to expire on 04/2021. Children’s records were reviewed and are in ordered. Facility has an updated roster and fire drill log available for review. Licensee last conducted a drill with the children in care on 01/15/2019.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include living room, kitchen, dining area, bedroom #1 and #2 and day care bathroom. Off limits areas include Bedroom #3 and #4 and bathroom (b) which there is a safety mesh net to prevent children's access. The home has sufficient toys and equipment available. Licensee stated that she brings the children to the nearby park for outdoor activities.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2019
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 2
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: GIL-CERVANTES, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 376625406
VISIT DATE: 06/11/2019
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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

The following items were discussed with provider: Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. Licensee was provided with information about Heat Related Illness, Sudden Infant Death Syndrome (SIDS), Never Shake a Baby, safe sleep for infants, Safe Sleep Regulation Concepts, Best practice on supervision, latest car seat poster and Effects of lead exposure and reporting responsibilities were discussed.



Licensee has the required immunizations for; Measles (MMR), Pertussis (DTAP) and Influenza.

Licensee was advised to email childcareadvocatesprogram@dss.ca.gov to request to be on the distribution list to obtain child care updates. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. Community Care Licensing website is www.ccld.ca.gov.

Facility appears to be in substantial compliance no citation issue.

A Notice of Site Visit was posted today, and it must remain posted for a period or 30 days. Failure to keep notice posted will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2019
LIC809 (FAS) - (06/04)
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