376627316-2-24-2022-20-CC-DSAZ-CBXQNQ-20220224111932

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376627316
Report Date: 02/24/2022
Date Signed: 02/24/2022 11:19:43 AM

Document Has Been Signed on 02/24/2022 11:19 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:	GARIBAY, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	376627316
ADMINISTRATOR:	MARIA GARIBAY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 730-0817
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91911
CAPACITY:	14	CENSUS: 5	DATE:	02/24/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Maria Garibay, Provider		TIME COMPLETED:	11:30 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 February 24, 2022, at 8:50 p.m., Licensing Program Analyst (LPA), D. Sanchez conducted an unannounced Annual Required inspection and met with the Licensee, Maria Garibay. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Five (5) children and one (1) staff were present in the facility during this inspection. This facility is a two story, 4 bedroom, 3 bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas used for child care are: dining room, kitchen, main daycare room located next to the kitchen, hallway bathroom, both bedrooms located on the first floor, side patio, and playground area located on the upper backyard patio. Off limits areas are second floor and garage and are inaccessible through use of door latch. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. All hazardous items were inaccessible to children. The storage area for poisons is locked. The licensee has toys, play equipment and materials available. The home has a fenced side yard and playground structure located on the upper backyard available for outdoor activities. No bodies of water observed on the premises during the inspection. Facility has a fountain on front yard but is not accessible to children. Licensee stated there are no weapons in the home. 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 or exemptions. Licensee’s First Aid and CPR certifications expire on 9/2023. Licensee has required immunizations. Licensee completed Mandated Reporter Training on 6/08/2021. Facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 10/2021. There is one crib and 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. The provider physically checks on sleeping infants every 15 minutes. Provider does not have Individual Infant Sleeping Plan [LIC 9227 (3/20)] for the infant that was present during the inspection. The provider places infants up to 12 months of age on their backs for sleeping.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana Sanchez	TELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022

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: GARIBAY, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 376627316
	VISIT DATE: 02/24/2022

NARRATIVE

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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 handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

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.

California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 809-D.

An exit interview was conducted with the licensee. 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 and observed it being posted at the facility.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana Sanchez	TELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 02/24/2022 11:19 AM - It Cannot Be Edited

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: GARIBAY, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 376627316
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above and did not have an Individual Infant Sleeping Plan for the infant that was present during the inspection, which posed a potential health and safety risk to persons in care.
	POC Due Date: 03/04/2022
	Plan of Correction
1 2 3 4	Provider stated that she will ensure to fill out the LIC-9227 with parent and submit a copy to the San Diego Child Care Regional Office (SDCCRO) by the due date 3/04/2022

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana Sanchez	TELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022

LIC809 (FAS) - (06/04)

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