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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628311
Report Date: 03/13/2020
Date Signed: 03/13/2020 02:02:55 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:GOMEZ, ERIKA & QUINONEZ, RAQUEL FAMILY CHILD CAREFACILITY NUMBER:
376628311
ADMINISTRATOR:ERIKA G. & RAQUEL Q.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 302-5311
CITY:CHULA VISTASTATE: CAZIP CODE:
91915
CAPACITY:14CENSUS: 8DATE:
03/13/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Erika Gomez & Raquel QuinonezTIME COMPLETED:
02:05 PM
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On March 13th, 2020 at 12:30 PM, Licensing Program Analyst (LPA), Jo Ann Legaspi conducted an unannounced Required - 1 Year Inspection and met with Staff Vicky Becerra Gutierrez. LPA disclosed the purpose of the inspection and was granted entry into the facility by staff. Eight (8) children and Staff Becerra Gutierrez were present in the facility during this inspection. None of the children were infants. Both Licensees arrived later during the inspection. The daycare operational schedule is weekdays 7 AM to 5 PM. This facility is a two story, three bedroom, three bathroom house. Staff accompanied LPA on a tour of the facility. The following areas are used for childcare: living room, dining room and downstairs bathroom. The second floor, kitchen and garage are the off limit areas. Child safety gates barricade the kitchen and stairs. A child safety knob is on the garage door.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. The last safety drill was 02/08/2020. Hazardous items were inaccessible to children. The licensee has toys, play equipment and materials available. Outdoor activities are conducted in the fenced and shaded backyard. Licensees acknowledged continuous, visual supervision is to be given to children whenever engaged in outdoor activities. Licensees do not provide transportation for children. Staff states there are no bodies of water on the premises and none were observed during tour. Licensee stated 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. Licensees’ First Aid and CPR certifications expire in May 2020. Staff’s First Aide and CPR certifications expire on 04/23/2021. Both Licensees completed Mandated Reporter Training on 04/07/2018. Fourteen of fourteen children’s records were reviewed; they were observed to contain immunization documentation and Notification of Parent’s Rights forms.

Incidental Medical services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020
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: GOMEZ, ERIKA & QUINONEZ, RAQUEL FAMILY CHILD CARE
FACILITY NUMBER: 376628311
VISIT DATE: 03/13/2020
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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.

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. Licensees were reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. Licensees were also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided Licensees 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.

No deficiencies observed in the evaluated areas.

LPA provided Licensees with the Notice of Site Visit – LIC 9213, which is to be posted for thirty (30) days. An exit interview was conducted with Licensees, who were provided a copy of the Licensee rights (LIC 9058 12/15); their signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020
LIC809 (FAS) - (06/04)
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