<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627129
Report Date: 09/20/2021
Date Signed: 09/20/2021 01:58:10 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:PALMA, LIZBETH FAMILY CHILD CAREFACILITY NUMBER:
376627129
ADMINISTRATOR:LIZBETH PALMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 929-4003
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY:14CENSUS: 10DATE:
09/20/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Lizbeth PalmaTIME COMPLETED:
02:15 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 September 20, 2021, at 12:30 p.m., Licensing Program Analyst (LPA), Gloria Gonzalez conducted an unannounced Annual Required Inspection and met with the Licensee, Lizbeth Palma.  LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee.  Ten (10) children and Three (3) staff were present in the facility during this inspection.  This facility is a one story, 4 bedroom, 2 bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas used for child care are: Living room, dining room, kitchen, hall bathroom, backyard, bedrooms #2 and #3.  Off limits areas are Master bedroom, master bedroom, bedroom #1, laundry room, and garage and are inaccessible through use of door knob covers and door lock. Hours of operation are: Monday through Friday 6:00am to 5:00pm.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements.  Hazardous items were made inaccessible to children during the inspection. The licensee has toys, play equipment and materials available. The home has a fenced backyard available for outdoor activities. Licensee states she contacted Licensing to advise of construction in her home, Licensee will be adding a room, kitchen, bathroom, and living room to the right side of the house. The area under construction is fenced off, children do not have access to that area. Licensee shall supervise children during outside activities at all times.  LPA advised to send in required documents to add the rooms. No bodies of water observed on the premises during the inspection. LPA observed locked storage areas for firearms and other dangerous 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 expire on 6/5/23.  Licensee has required immunizations.  Licensee completed Mandated Reporter Training on 2/5/21. Facility roster is maintained and was reviewed.  The last fire and disaster drills were conducted and documented on 7/2/21. There is one crib or play yard for each infant who is unable to climb out of the crib or play yard.  Cribs or play yards are free from all loose articles and objects. Licensee physically checks on sleeping infants up to 24 months of age every 15 minutes.  An Individual Infant Sleeping Plan [LIC 9227 (3/20)] will be maintained for each infant up to 12 months of age.  Licensee places infants up to 12 months of age on their backs for sleeping.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2021
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 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: PALMA, LIZBETH FAMILY CHILD CARE
FACILITY NUMBER: 376627129
VISIT DATE: 09/20/2021
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 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.  Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare.  Licensee was also provided information regarding Safe Sleep Regulation Section 102425, SIDS, Lead exposure and Shaken Baby Syndrome.  LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov

Duty Line at (619) 767-2248. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov. LPA advised if there is an unusual incident to report to call Licensing and to follow up with an LIC624B within 7 days.

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions, questions regarding licensing requirements.

This facility provides Incidental Medical Services – IMS.  LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.   For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417.  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 cited.

The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.  LPA provided notice of site visit (LIC 9213) and observed it being posted at the facility.

LPA explained the inspection report to licensee, licensee stated she understood.

An exit interview was conducted with the licensee.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2