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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628150
Report Date: 09/14/2021
Date Signed: 09/14/2021 12:15:44 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 HERNANDEZ, LILIA FAMILY CHILD CAREFACILITY NUMBER:
376628150
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
09/14/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lilia ContrerasTIME COMPLETED:
12:30 PM
NARRATIVE
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On 9/14/21 at 9:00 AM, Licensing Program Analyst (LPA) Adrian Mangina conducted an unannounced Annual inspection with the Licensee. Upon arrival, LPA met with Licensee, Lilia Hernandez Contreras. The one-story three bedroom one bathroom home was toured and inspected to ensure an environment safe for the care and supervision of children. Also present in the home were Francisco Duran, Licensee's husband three day care children and licensee’s own minor child. Proper supervision and ratios were observed. Upon arrival LPA observed that Francisco Duran was assisting with the children in care by feeding a child in a high chair and he states that he is a helper in the child care. The 2A10BC fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. During the inspection, LPA observed that two outlets in dining room were not covered and that in the bathroom, there were chemicals under sink in an unlatched cabinet. Licensee covered outlets and latched the cabinet while LPA was present. In the bedroom that leads to the back patio, LPA observed that one of three cribs, had a mobile affixed to the crib’s side making it hang over the crib and also a noise machine hanging from the crib side that had a wire attached that hung directly next to the slats of the crib and easily in gabbing distance from from inside the crib. Licensee removed the mobile and sound machine while LPA was present. LPA observed that there is a swing set and slide in the accessible back patio which has a baby swing installed and has only fake grass as padding underneath. LPA advised that there is insufficient padding under the swing set for safety and it cannot be used for children in care. Licensee’s husband states that the swing set is only used for his child. Licensee states that 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 9/21/2023. Licensee states that her helper Francisco Duran is not left home alone with the children and does not have First Aid and CPR certifications. Licensee and helper meet immunization requirements. LPA observed that helper does not have a personnel file, but helper did provide LPA with his immunization record.

(continued on LIC809 page 2)
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021
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 5
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 HERNANDEZ, LILIA FAMILY CHILD CARE
FACILITY NUMBER: 376628150
VISIT DATE: 09/14/2021
NARRATIVE
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LPA observed that there is no employee file for Francisco Duran and there is no LIC9108 Statement Acknowledging Requirement to Report Child Abuse, or Mandated Reporter Training Certificate for helper, as required. Licensee states that she took Mandated Reporter Training when first Licensed but is not able to find the certificate. Licensee could not provide LPA with a current Mandated Reporter training certificate. LPA was unable to find a copy of that original certificate in her facility file. Licensee was reminded that both she and any helper both need to have current Mandated Reporter training certificates on file, with training required every two years. Licensee maintains emergency records for children. The last disaster drill was conducted 7/2/21

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include: living room, dining area, bathroom and bedroom #2. Off limits areas include: kitchen, bedroom #1, bedroom #3 and back patio and are made inaccessible through use of baby gates, latches and locks. Licensee advised to install a screw lock to the top of the sliding glass door to make the patio inaccessible to children. There are no bodies of water on the premises. There is a working phone at the facility. The licensee has sufficient safe age appropriate, toys and equipment available. Licensee uses a local park for outdoor activities. Visual supervision is required at all times when children are outside.

Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances associated to the facility, corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA Mangina reviewed Covid-19 guidelines with Licensee and provided Covid-19 resources. LPA Mangina directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.

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
(continued on LIC809 page 3)
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021
LIC809 (FAS) - (06/04)
Page: 2 of 5
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 HERNANDEZ, LILIA FAMILY CHILD CARE
FACILITY NUMBER: 376628150
VISIT DATE: 09/14/2021
NARRATIVE
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(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.

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.

See LIC 809D for Deficiencies cited during visit and LIC9102 for Technical Assistance given.

An exit interview was conducted with the Licensee. The Licensee was provided a copy of their appeal rights (LIC 9058) along with a copy of this report (LIC 809). Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide Acknowledgement of Receipt of Licensing Reports (LIC 9224) to the parent/guardian of for each child in care for signature acknowledging receipt of copy of this report. THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
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 HERNANDEZ, LILIA FAMILY CHILD CARE
FACILITY NUMBER: 376628150
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/15/2021
Section Cited

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Infant Safe Sleep: Cribs or play yards shall be free from all loose articles and objects.
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This requirement was not met as evidenced by: LPA observed a mobile hanging over crib and a noise machine hanging from crib with a charging wire attached which poses an immediate health and safety risk to children in care.
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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: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2021
LIC809 (FAS) - (06/04)
Page: 5 of 5
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 HERNANDEZ, LILIA FAMILY CHILD CARE
FACILITY NUMBER: 376628150
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/14/2021
Section Cited

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Personnel records: Personnel records shall be maintained on each employee...

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This requirement was not met as evidenced by: Licensee's husband was observed feeding infant and she states he is a helper in the child care. Licensee does not have a personnel fiile for him which poses a potential health and safety risk to children in care.
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Type B
10/13/2021
Section Cited

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Availability of information regarding...training for mandated reporter: The licensee of a licensed child day care facility shall obtain proof... employee of the facility... has completed mandated reporter training
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This requirement was not met as evidenced by:
Neither Licensee or her helper/husband could provide LPA with a current Mandated Reporter Training Certificate.
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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: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5