376628204-7-26-2019-20-CC-DSAZ-BEFUAU-20190726152518

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628204
Report Date: 07/26/2019
Date Signed: 07/26/2019 03:25:22 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:	RODRIGUEZ, MAYRA & WIFREDO FAMILY CHILD CARE HOME		FACILITY NUMBER:	376628204
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 2	DATE:	07/26/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Mayra Rodriguez		TIME COMPLETED:	03:30 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) D. Sanchez made an unannounced Case Management inspection in response to the increase of capacity request. LPA was greeted and allowed entry into the facility by Wilfredo Rodriguez, who was advised of the purpose of today’s inspection. Also present in the facility was provider Mayra Rodriguez. LPA accompanied by Mayra conducted a general overall inspection of the facility. The facility is a single story three bedroom home. The following areas are used for day-care: Family room, living room, kitchen, dining room, two bedrooms and backyard. Off limits areas includes: master bedroom and garage. LPA noticed that all required notices, License and forms were properly posted. The house smoke and carbon monoxide detectors are operable and fire extinguisher is fully charged. The day care bathroom was inspected; the toilet and faucets are operational. The kitchen drawers are secured, sharps and chemicals are out of the reach of children. The backyard is fully fenced, there are plenty of toys and equipment for outside activities. A review of all adults living in this home who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR are up to date. Provider stated that they do not have hand gun or ammunition in this house. The maximum number of children for whom care shall be provided when there is an assistant provider in the home, including children under age 10 who live in the licensee's home and the assistant provider's children under age 10, shall be either: Twelve (12) children with no more than four of whom may be infants or Fourteen (14) children, at least two of the children are at least six years of age and no more than three infants with landlord consent. Facility is currently in substantial compliance; all requirements for a large license have been met. A large license for a maximum capacity of 14 children will be granted effective today 7/26/2019.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana Sanchez	TELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2019

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: RODRIGUEZ, MAYRA & WIFREDO FAMILY CHILD CARE HOME	FACILITY NUMBER: 376628204
	VISIT DATE: 07/26/2019

NARRATIVE

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LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

Community Care Licensing WEB SITE: http://www.ccld.ca.gov

LPA gave provider a copy of the SIDS safe sleep printout information and advised her of the importance of child abuse reporting, children’s records, immunization, shaken baby syndrome and the YMCA Resource Center. LPA explained clearance requirements for persons over 18 residing or working in the facility. Provider understood that physical discipline/corporal punishment and smoking shall never be permitted in the child care program. Provider was also advised that exersaucers, bouncy, rockers, walkers shall never be permitted in the child care program.

No deficiencies were cited during today's visit. An exit interview was conducted with Mayra Rodriguez and Wilfredo Rodriguez a copy of this report left at the facility.

LPA observed provider placing the Notice of Cite Visit on the wall visible to parents during today’s inspection.

NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana Sanchez	TELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2019

LIC809 (FAS) - (06/04)

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