376627141-9-2-2020-20-CC-MHOD-BT3SJ9-20200902135447

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376627141
Report Date: 09/02/2020
Date Signed: 09/02/2020 01:55:54 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:	HERRERA, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	376627141
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	09/02/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Maria Herrera, Licensee		TIME COMPLETED:	02:10 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	Licensing Program Analyst (LPA) Michelle Hood made an unannounced tele-inspection for the purpose of an increase in capacity. Licensees daughter translated in Spanish. On 08/27/2020, a fire clearance was approved for 14 children. Licensee will use the following areas for child care: living room, dining room, kitchen, bathroom, and backyard. The off limit areas are made inaccessible via locks and door knob covers. There are no bodies of water observed during time of visit. There is a sufficient amount of age appropriate toys, games, and books available. The home was clean and orderly, with comfortable temperature and ventilation for safety and comfort during the inspection. The fire extinguisher is rated 2-A;10; BC, smoke alarm and carbon monoxide detector are operational. There is a working telephone in the home and all required forms are posted. Licensee stated that there are NO firearms or ammunition on the property. All adults living or working in the home have been fingerprint cleared and associated. LPA reviewed children's files and emergency drill log. Licensee will e-mail LPA a copy of the children's roster. Last fire/disaster drill was conducted 08/28/2020. Pediatric CPR and First Aid certification expire 10/2020. LPA discussed with licensee maintaining supervision of daycare children at all times. LPA reviewed the following with licensee: SIDS, car seat law, reporting requirements, shaken baby syndrome and care and supervision. LPA provided licensee PIN 20-04 and 20-06 CCP. Licensee was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care. 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.html

SUPERVISOR'S NAME: Joe Carrasco	TELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2020

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: HERRERA, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 376627141
	VISIT DATE: 09/02/2020

NARRATIVE

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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 is no Qualified Assistant, 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.

LPA reviewed this report with Licensee. Licensee will confirm receipt of this report and via e-mail and the reply of confirmation will serve as the signature acknowledging these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

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

SUPERVISOR'S NAME: Joe Carrasco	TELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2020

LIC809 (FAS) - (06/04)

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