376627129-2-3-2022-20-CC-MHOD-CBAT76-20220203132812

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376627129
Report Date: 02/03/2022
Date Signed: 02/03/2022 01:29:11 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 CARE		FACILITY NUMBER:	376627129
ADMINISTRATOR:	LIZBETH PALMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 929-4003
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92154
CAPACITY:	14	CENSUS: 10	DATE:	02/03/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Lizbeth Palma, Licensee		TIME COMPLETED:	12:15 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 02/03/2022 at 11:00 am, Licensing Program Analyst (LPA), Michelle Hood conducted an unannounced case management inspection with the licensee, Lizbeth Palma. LPA notified the licensee the purpose of the inspection was to inspect the new addition to the facility and the licensee led LPA on a tour of the facility. There were ten (10) children and three (3) staff at the facility during the time of the inspection. On 01/11/2022, the San Diego Fire-Rescue Department granted the new home addition which includes a bedroom, kitchen, living room and bathroom room. Licensee will use the following areas for child care in the main home as needed: living room, bedroom #3 (isolation room), bathroom #1, kitchen #1, and dining room. The new addition to the home will be used for daycare: kitchen #2, bedroom #4, bathroom #2, play area and backyard. The parents will enter through the gate on the east side of the garage. The off-limits area is made inaccessible via safety gates and doorknob covers. There are no bodies of water observed during the time of inspection. There is a sufficient amount of age-appropriate toys, games, and books available. The home was clean and orderly during the inspection. The fire extinguisher is rated 2-A;10; BC, smoke alarm, and carbon monoxide detector are operational. The is a working telephone in the home and all required forms are posted. The licensee stated there are firearms or ammunition on the property. The 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 exemption, prior to the 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. Any minor upon his/her 18^th birthday must be fingerprinted within 30 days. The licensee provided LPA a copy of the facility roster. The last fire/disaster drill was conducted 12/13/2021. Pediatric CPR and First Aid certification expire 06/2023. Licensee was also reminded the following items are prohibited during daycare operating hours (walkers, exersaucers, jumpers, and bouncy seats). Corporal punishment and smoking are not allowed in the daycare. Licensee provides Incidental Medical Services (IMS). IMS plan on file. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.html

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (691) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

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: PALMA, LIZBETH FAMILY CHILD CARE	FACILITY NUMBER: 376627129
	VISIT DATE: 02/03/2022

NARRATIVE

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LPA discussed the safe sleep regulations with the 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 the 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. The licensee understands they must physically check on sleeping infants every 15 minutes. Licensee uses Bright Wheel for sleeping log. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] will be maintained for each infant up to 12 months of age and shall be available to the Department for review. The licensee understands infants up to 12 months of age must be placed on their backs for sleeping.

The maximum capacity for a large family child care home: 12 children (with a qualified assistant) with no more than 4 infants; or (with landlord consent) 14 children (with a qualified assistant) with no more than 3 infants, 1 child enrolled in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. When there are no Qualified Assistants, 14 years of age or present, the capacity reverts back to the requirements for a Small Family Child Care. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

A copy of the licensing report and appeal rights were provided to the licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. An exit interview was conducted with licensee Lizbeth Palma..

A Regular Large Family Child Care Home license may be issued for 14 children upon final file review.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (691) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

LIC809 (FAS) - (06/04)

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