376628244-5-17-2019-20-CC-JARL-BC9R4H-20190517124131

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628244
Report Date: 05/17/2019
Date Signed: 05/17/2019 12:41:43 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:	MONTALVO, MARINA FAMILY CHILD CARE		FACILITY NUMBER:	376628244
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	05/17/2019
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Marina Montalvo		TIME COMPLETED:	12:00 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) Jo Ann Legaspi conducted an unannounced capacity increase inspection. Licensee Marina Montalvo was advised of the visit’s purpose and granted LPA facility entry. The daycare is a two (2) story single family home. It has six (6) bedrooms, and three (3) bathrooms. The home was toured and inspected to ensure an environment safe for the care and supervision of children. The second-floor stairs are barricaded with a child safety gate. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. Hazardous items were secured out of reach of children. Per the Licensee, no weapons are 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. The home appears to be large enough to comfortably accommodate fourteen (14) children. Fire clearance was received on 05/13/2019. First Aid and CPR certifications expire on 04/02/2021. The downstairs rooms will be used for care; these rooms are the living room, one (1) bathroom, family room, dining room and kitchen. The second floor will be off limits. Licensee has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. LPA provided Licensee with Provider Information Notice (PIN) 19-02-CCP regarding Safe Sleep Awareness, additional written information and information resources about safe sleep techniques. LPA and Licensee discussed those methods of protected slumber. Licensee was also provided with written information regarding lead exposure as per Assembly Bill 2370. LPA advised Licensee that all parents must receive this written information about lead exposure. Also provided to the Licensee was the “Heart and Nutrition” newsletter. Licensee and LPA reviewed these issues. LPA and Licensee discussed California Megan's Law. LPA provided the website: www.meganslaw.ca.gov.

SUPERVISOR'S NAME: Carolina Ramos	TELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

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 2

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: MONTALVO, MARINA FAMILY CHILD CARE	FACILITY NUMBER: 376628244
	VISIT DATE: 05/17/2019

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
26
27
28
29
30
31
32

The provider was 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 to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care.

The Incidental Medical Services (IMS) policy was discussed. 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 Community Care Licensing. 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.

LPA provided the Licensee with the Notice of Site Visit – LIC 9213. This notice is to be posted for thirty (30) days.

The home appears to be in sufficient compliance and no corrections are needed. A license for fourteen (14) children will be issued effective today (05/17/2019). The Licensee agreed that the new license will be mailed to the facility via certified post.

An exit interview was conducted with the Licensee, who was provided a copy of their Licensee Rights (LIC 9058 1/16). Their signature on this form acknowledges receipt of these rights.

SUPERVISOR'S NAME: Carolina Ramos	TELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2