376625443-1-27-2021-20-CC-RGOU-BXNVAL-20210127151607

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376625443
Report Date: 01/27/2021
Date Signed: 01/27/2021 03:16:28 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:	CARDENAS, BLANCA FAMILY CHILD CARE		FACILITY NUMBER:	376625443
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	01/27/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:48 PM
MET WITH:	Blanca Cardenas		TIME COMPLETED:	02:00 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 01/27/21 at 12:48 p.m. Licensing Program Analyst (LPA), Rajani Goudreau conducted an unannounced case management – licensee initiated visit. Upon visit, LPA met with licensee, Blanca Cardenas and proceeded to tour the home. Also, present in the home at time of visit, licensees adult daughter and minor son. Licensees' daughter assisted in translating the inspection. Facility operates Monday through Sunday; 24 hours. The purpose of today’s visit is to inspect the pool fencing located in the backyard in order to determine if it meets title 22 regulations. In addition, the licensee is requesting a capacity increase. All cleaning compounds, detergents, medications and other items which could pose a danger to children are stored where they are inaccessible to children and poisons are to be locked away. The fire extinguisher, smoke and carbon monoxide detectors meet requirements and are operational. LPA observed required postings posted. Children’s toys and play equipment are safe and age appropriate. There are no firearms or other weapons in the home, per licensee. Primary telephone is a cell phone which is operational. Pediatric CPR and First-Aid certificate are valid through 04/2022. A review of clearances on this date indicates that all individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee rents the facility and has provided proof of control of property by a rental agreement, landlord consent on file. Licensee has met immunization requirement, per SB792 and has completed the AB1207 Mandated Reporter Training in 10/2020. Lead poisoning certificate on file. Licensee has more than one year of experience as a regulated small family child care home operator. Licensee is scheduled to retake the Preventative Health training to satisfy the one hour of nutrition on 01/28/21. Children will not utilize the backyard for outdoor play. There is a driveway that leads to the back of the home. The children will utilize the front yard for outdoor play. LPA informed licensee to ensure children are supervised at all times during outdoor activities. LPA discussed and reminded Licensee she is responsible for the health and safety of all the children in her care. See LIC809-Continuation page...

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2021

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 3

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: CARDENAS, BLANCA FAMILY CHILD CARE	FACILITY NUMBER: 376625443
	VISIT DATE: 01/27/2021

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 inspected the backyard and the pool fencing. The pool is located near the back of the house, which 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. There is a garage located near the right side of the pool. The pool fencing stops at the left back corner edge of the garage. There is no openings between the garage and the pool fencing. There is no windows or doors on the garage that lead to the pool area, per observation. The garage entrances are on the outside of the pool fencing. At time of visit, LPA took pictures of the pool fencing, the pool gate and the outside of the garage.
The pool fencing meet title 22, division 12, chapter 1 regulations. Facility self-certification and the COVID-19 Facility Assessment checklists are on file. See LIC809 continuation page…

The following areas are used for childcare: living room, dining room and bathroom located in the living room area and front yard. The following areas of the home are off-limits: the garage, back yard, kitchen, bedrooms #1, #2, #3 and #4, bathroom located in bedroom #4 and the laundry room. Bedroom #4 is attached to the house; however, there is no internal access to the bedroom from the inside of the home. Bedroom #4 is accessible through the back of the home in the backyard. All off-limit areas of the home are made securely inaccessible:

The fire Clearance was granted on December 14, 2020. The garage was not inspected by the Fire Marshall as the garage will not be used for child care, per fire clearance.

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 provided 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 is needed, prior to the issuance of the capacity increase with a due date of 02/05/21:

Live scan clearance, LIC508 -Criminal Record Clearance, I.D and T.B. clearance for Adult son
Preventative Health with Nutrition certificate reflecting completion of the training

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: 01/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: CARDENAS, BLANCA FAMILY CHILD CARE	FACILITY NUMBER: 376625443
	VISIT DATE: 01/27/2021

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 discussed California Megan's Law and provided the following to licensee with the following website: www.meganslaw.ca.gov. LPA informed applicant in order to access CCLD-Childcare regulations, licensing forms, pay the annual fee to visit the following website: http://ccld.ca.gov. LPA discussed the following with licensee: to sign up for Quarterly Updates and PINs for one or more programs through our website. Please go to www.cdss.ca.gov and on the right side of your screen click on “Receive Important Updates”, put your email address in and choose which program(s) you would like to subscribe to and click “subscribe. In addition, for questions contact Child Care Licensing duty line at 619-767-2248. LPA discussed lead poisoning effects brochure and information on SIDS, shaken baby syndrome.

LPA discussed the following with licensee: Max capacity when there is an assistant present: 12 children-no more than 4 infants (birth to 24 months). When caring for 14 children no more than 3 infants. 1 child in kindergarten and 1 child at least 6 years old. When there is no qualified assistant the capacity reverts back to the requirements from a small childcare. You must notify the parents of the children in care when caring for more than 12 children.

No deficiencies issues during today’s visit. An exit interview was conducted with licensee. The following was discussed and will be provided to the licensee via email: LIC809 reports, LIC9213 – Notice of Site Visit and appeal rights. After pending documents are received and after final file review a large family childcare license will be issued and mailed to the licensee. LPA informed licensee, once license is received to post in a prominent place in home. LPA informed licensee once LIC9213 is received to post for 30 days from today’s date. COVID-19 State of emergency read receipt notification will be used in place of licensee’s signature.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2021

LIC809 (FAS) - (06/04)

Page: 3 of 3