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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628181
Report Date: 02/04/2020
Date Signed: 02/04/2020 01:49:18 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:CHAPA, CLAUDIA FAMILY CHILD CAREFACILITY NUMBER:
376628181
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
02/04/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:21 PM
MET WITH:Claudia Chapa, Licensee TIME COMPLETED:
02:10 PM
NARRATIVE
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Licensing Program Analyst (LPA) Elizabeth Rivera conducted an unannounced case management visit to the facility today with the purpose to clear deficiencies but LPA observed a repeat of the violation on today's visit. The deficiencies are based on LPA's observation and Licensee's admission. Present was the licensee and 7 day-care children including 3 infants.

See LIC 809D for cited deficiencies on today's visit with a $250.00 civil penalty. LPA explained to Licensee ratio/capacity requirements a second time and Licensee stated she understood and posted ratio/capacity worksheet provided by LPA.

Upon receipt of a type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

Signature at the bottom of this report confirms receipt.  Notice of Site Visit was posted during this visit and will remain posted for 30 days.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Elizabeth RiveraTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
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: CHAPA, CLAUDIA FAMILY CHILD CARE
FACILITY NUMBER: 376628181
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/04/2020
Section Cited

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(b) For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time...(2) Six children, no more than three of whom may be infants... This requirement was not met as

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evidenced by: Based on LPA's observation and Licensee's own admission. Licensee did not provide care for the maximum amount of 6 children when providing care for 3 infants. Upon LPA arrival Licensee had 3 infants and 4 toddlers. This poses an immediate Risk for 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: Elizabeth RiveraTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:
DATE: 02/04/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2020
LIC809 (FAS) - (06/04)
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