376626429-3-23-2023-20-CC-JARL-CQ7PW2-20230323113959

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376626429
Report Date: 03/23/2023
Date Signed: 03/23/2023 11:40:17 AM

Document Has Been Signed on 03/23/2023 11:40 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:	GONZALEZ, JESSICA FAMILY CHILD CARE		FACILITY NUMBER:	376626429
ADMINISTRATOR:	JESSICA GONZALEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 213-7544
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91913
CAPACITY:	14	CENSUS: 6	DATE:	03/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Jessica Gonzalez		TIME COMPLETED:	09:50 AM

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 March 23^rd, 2023, at 7:45 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted an unannounced Annual Required Inspection and met with the Licensee Jessica Gonzalez. LPA disclosed the purpose of the inspection and was granted facility entry by the Licensee. The Licensee and six (6) children were present in the facility during this inspection. This facility is a two (2) story, five (5) bedroom, four (4) bathroom house. Licensee accompanied LPA during this inspection. The following areas used for childcare are: living room, one (1) downstairs bathroom, family room and the fenced/shaded backyard. The off limit areas are the garage, laundry room, kitchen, and the top floor. The remaining bedrooms and bathrooms are located on the top floor. Stairs to the top floor are barricaded with child safety gates. The doorknobs to the garage and laundry room are covered with doorknob safety covers. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. Hazardous items were observed inaccessible to children during this inspection. The Licensee has available toys, play equipment and materials. Licensee states children play outside in the fenced/shaded backyard and take neighborhood walks for outdoor activities. Licensee was reminded that continuous supervision is to be given to children whenever engaged in outdoor activities. No bodies of water were observed on the premises during the inspection. Licensee stated there are no weapons in the home. The Licensee has one small (1) dog that has occasional contact with daycare children. Licensee’s First Aid and CPR certifications expire on 01/25/2025. Licensee has required immunizations. Mandated Reporter Training was completed on 03/03/2022. The facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 02/16/2023 and 02/23/2023. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

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: GONZALEZ, JESSICA FAMILY CHILD CARE	FACILITY NUMBER: 376626429
	VISIT DATE: 03/23/2023

NARRATIVE

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exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA provided Licensee with Provider Information Notice (PIN) 20-24-CCP, a blank LIC 9227 “Individual Infant Sleeping Plan” form and two (2) examples of safe sleep logs. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reminded Licensee of 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.

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.

LPA provided Licensee with PIN 22-31-CCP, PIN 22-22-CCP and PIN 23-04-CCLD. PIN 22-31-CCP provides information about the new MyChildCarePlan.org website, a resource that can assist families in finding available childcare. This website provides a childcare search tool that connects parents to childcare providers and Resource and Referral Agencies throughout California. PIN 22-22-CCP notifies licensed Family Child Care Home providers about the availability of the Family Child Care Home License Incentive Payment related to COVID-19 pandemic relief. PIN 23-04-CCLD states that pre-pandemic reporting requirements now apply

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

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: GONZALEZ, JESSICA FAMILY CHILD CARE	FACILITY NUMBER: 376626429
	VISIT DATE: 03/23/2023

NARRATIVE

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due to the end of the COVID 19 State of Emergency.

No deficiencies observed.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the Licensee Jessica Gonzalez.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

LIC809 (FAS) - (06/04)

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