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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376625442
Report Date: 07/17/2019
Date Signed: 07/17/2019 01:36:51 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:GONZALEZ, BERTHA FAMILY CHILD CAREFACILITY NUMBER:
376625442
ADMINISTRATOR:BERTHA GONZALEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 779-5337
CITY:SAN DIEGOSTATE: CAZIP CODE:
92102
CAPACITY:14CENSUS: 15DATE:
07/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Bertha GonzalezTIME COMPLETED:
01:45 PM
NARRATIVE
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(3) Licensing Program Analysts (LPAs) Selina Siao and Michelle Palacio 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, her husband Jesus Gonzalez, her two children that are over 14 years old helping with 15 children including four school age children, three infants and 8 preschool age children. Three out of the 15 children are licensee's grandchildren. A day care parent arrived at the facility to pick up one preschool age children within 10 minutes. The facility was observed to be out of licensed capacity by one child. The home has a fully charged fire extinguisher size 2A10BC, smoke and carbon monoxide detector that meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water observed at the facility and licensee stated that the home does not have any 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 or exemptions. Licensee is registered to renew her CPR and First Aid course on 07/28/19. All the 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 05/18/2019 and an earthquake drill was conducted with the children on 05/27/2019.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include the living room, kitchen, dining room, kid room and main bathroom. Off limit areas are the three bedrooms and bathroom. Licensee was advised to put a door knob cover for all the off limit areas. Facility has ample toys and equipment available. The home has a large fenced backyard available for outdoor activities.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
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 4
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, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 376625442
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/22/2019
Section Cited
CCR
102416.5(f)
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The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children. This requirement was not met as evidence by: Upon arrival, LPAs observed 15 children. About 10 minutes later,
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Licensee stated that she will be sure to have the parents arrive on time. She stated that if a child that is dropped off will caused her to be out of capacity or ratio then she will have that parent wait until the other
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a parent arrived at the facility to pick up a day care child. Facility was out of capacity by one child. This poses a potential health and safety risk to clients in care.


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child is picked up from the facility. Licensee will talk to her parents regarding the importance of arriving at the facility on time and a written plan of correction will be submitted to Analyst by 07/22/2019.
Type B
08/06/2019
Section Cited
HSC
1597.622(4)(c)
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The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home.
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Licensee stated that her husband will get the immunization from his doctor's office. A copy of the required immunization will be submitted to Analyst no later than 08/06/2019.
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This requirement was not met as evidence by: Licensee's husband Jesus Antonio Gonzalez's immunization record for MMR, TDAP and influenza is not available for review. This poses a potential health and safety risk to clients in care.
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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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 376625442
VISIT DATE: 07/17/2019
NARRATIVE
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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, best practice on supervision, latest car seat poster and Effects of Lead Exposure and reporting responsibilities were discussed.

Per new Senate Bill 792 pertaining to immunizations, which require all adults in daycare operation to have proof of immunizations for; Measles, Pertussis and Influenza. Licensee has current verification of required immunizations for herself, but she doesn't have the information for her husband.


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.

See LIC809D for deficiencies:


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. Provided appeal rights to licensee today.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 376625442
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/06/2019
Section Cited
HSC
1596.8662(4)(b)(1)
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 On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child 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
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Licensee stated that she will have her husband complete the online mandated child abuse training. Licensee will submit the proof of completion certificate to Analyst no later than 08/06/2019.
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complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement was not met as evidence by: Licensee's husband Jesus Antonio Gonzalez's has not taken the online mandated child abuse training. This poses a potential health and safety risk to clients in care.


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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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4