376625439-9-1-2021-20-CC-RGOU-C6FR78-20210901124555

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376625439
Report Date: 09/01/2021
Date Signed: 09/01/2021 12:46:23 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:	DELGADO, ALICIA & JOSE FAMILY CHILD CARE		FACILITY NUMBER:	376625439
ADMINISTRATOR:	ALICIA & JOSE DELGADO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 741-4788
CITY:	LEMON GROVE	STATE: CA	ZIP CODE:	91945
CAPACITY:	14	CENSUS: 6	DATE:	09/01/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:34 AM
MET WITH:	Alicia & Jose Delgado		TIME COMPLETED:	12:12 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 09/01/21, at 10:34 a.m., Licensing Program Analyst (LPA), Rajani Goudreau conducted an unannounced Annual Inspection and met with the Licensees, Alicia and Jose Delgado. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensees. Six children were present in the facility during this inspection. This facility is a one story, two-bedroom and two bathroom house. The following areas are used for childcare: living room, kitchen, bathroom located in hallway of home, front yard and back yard. The following off-limit areas are made securely inaccessible: two bedrooms, bathroom located in the master bedroom and garage. Operation hours are Monday to Friday from 6:00 a.m. to 6:00 p.m. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements, per LPA observation. LPA observed hazardous items inaccessible to children in care. LPA informed licensees poisons shall be placed in a storage area and locked. LPA observed toys, play equipment and materials available for the children’s use. The home has a fenced backyard available for outdoor activities. LPA informed licensee children shall be supervised during outdoor activities. There is a pool located in the backyard of the home. Pool in back yard is fenced with a 5 feet high fence with openings on fence no wider than four inches, and in no way obstruct a complete and clear view of the pool from the outside. In addition, pool fence has a gate that is self-closing, self-latching and swings away from the pool, per LPA observation. LPA informed Licensees, the gate shall be closed when not in use, and not locked, if it may be necessary for an adult to enter the pool area without having to find a key or remember a combination. Licensees stated there are no weapons in the home. 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 or exemptions. Licensee First Aid and CPR certifications are valid and expire on 05/2023. Licensees has required immunization's, per file review. Licensees have completed the Mandated Reporter Training on 01/2021. LPA informed licensees the Mandated Reporter training shall be completed once every two years. The facility roster is maintained and was reviewed. The last fire and disaster drills were conducted within 6 months and documented. LPA discussed the Safe Sleep regulations (CCR 102425). See LIC809-C continuation page…

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021

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: DELGADO, ALICIA & JOSE FAMILY CHILD CARE	FACILITY NUMBER: 376625439
	VISIT DATE: 09/01/2021

NARRATIVE

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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. Licensees were 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 Safe Sleep Regulations/SIDS, and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided Licensees 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.

No deficiencies issued during today's visit. LPA conducted an exit interview with licensees. LPA discussed and provided the following: LIC809, LIC809-C, LIC9213-Notice of Site Visit and appeal rights. LPA informed licensees Notice of Site Visit shall be posted for 30 days from today's date.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021

LIC809 (FAS) - (06/04)

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