376628221-7-30-2021-20-CC-ACAN-C5EJ2K-20210730064003

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628221
Report Date: 07/29/2021
Date Signed: 07/30/2021 06:40:46 AM

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:	ALVAREZ, ALEXIZ FAMILY CHILD CARE		FACILITY NUMBER:	376628221
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	07/29/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Alexiz Alvarez		TIME COMPLETED:	02:30 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	On 07/29/2021, at 1:30 p.m., Licensing Program Analyst (LPA), Adrian Castellon conducted an unannounced Annual Required Inspection and met with licensee Alexiz Alvarez. LPA discussed the purpose of the inspection and was granted entry into the facility by the Licensee. There were six children present in the facility during this inspection. The following areas are used for daycare purposes: living room, kitchen and the hallway bathroom. Licensee accompanied LPA Castellon inside and out of the facility during this inspection. A fully fenced back patio will be used for daycare purposes. The front yard is fenced but will not be used for daycare purposes. The fire extinguisher, smoke detector and carbon monoxide detector meet 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. Licensee stated there are no weapons in the home. 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 are current and expire 01/22. Licensee has required immunization's. Roster is maintained. Emergency disaster drill requirement was discussed. Licensee is providing infant care. Children's files reviewed on this date. 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.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

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: ALVAREZ, ALEXIZ FAMILY CHILD CARE	FACILITY NUMBER: 376628221
	VISIT DATE: 07/29/2021

NARRATIVE

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Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome was discussed. 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.

SAFE SLEEP PLAN and documentation was discussed. The provider physically checks on sleeping infants every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age and shall be available to the Department for review. The provider places infants up to 12 months of age on their backs for sleeping.

An exit interview was conducted with the licensee. The licensee was provided a copy via email. No citations issued on this date.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

LIC809 (FAS) - (06/04)

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