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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627662
Report Date: 07/22/2021
Date Signed: 07/22/2021 02:45:16 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:CONTRERAS, ROCIO FAMILY CHILD CAREFACILITY NUMBER:
376627662
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
07/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Rocio Contreras, LicenseeTIME COMPLETED:
02:45 PM
NARRATIVE
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On July 22, 2021, at 1:00 PM, Licensing Program Analysts (LPA's), Marie Hernandez and Crystal Tillory conducted an unannounced Annual Required Inspection and met with the Licensee, Rocio Contreras. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. During the inspection, there were two infants, four toddlers and two school aged children present with the Licensee This facility is a one story, three bedroom, and two bathroom home. The Licensee accompanied LPA inside and out of the facility during this inspection. The following areas are used for child care are: The kitchen, dinning room, living room , hallway bathroom, bedroom #1 and the backyard. The off limits areas are inaccessible. through use of a child proof safety gate and child proof door knobs.

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. No bodies of water observed on the premises during the inspection. The 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 a criminal record and child abuse clearances or exemptions. Licensee’s First Aid and CPR certifications expired on 05/01/2023. Licensee has the required immunization's. The Licensee's Mandated Reporter certification expired on 06/26/2018. The Licensee conducted the fire/disaster drill on 05/17/2021. LPA discussed and provided the Safe Sleep handouts including the Individual Infant Sleeping Plan [LIC 9227 (3/20)]. The Licensee stated it is understood. 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 day-care. 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.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Marie HernandezTELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
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 3
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: CONTRERAS, ROCIO FAMILY CHILD CARE
FACILITY NUMBER: 376627662
VISIT DATE: 07/22/2021
NARRATIVE
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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), is 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: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Marie HernandezTELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: CONTRERAS, ROCIO FAMILY CHILD CARE
FACILITY NUMBER: 376627662
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/29/2021
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete and renew the mandated reporter training every two years. This requirement was not met as evidenced by:
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LPA during records review. The Licensee's mandated reporter certification expired on 06/26/2018.

This poses a potential health and safety risk to children in care.
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The appeal rights were discussed and provided.

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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: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Marie HernandezTELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3