376628323-5-30-2019-20-CC-YBAZ-BCNUAQ-20190530152506

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628323
Report Date: 05/30/2019
Date Signed: 05/30/2019 03:25:13 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:	GONZALEZ, ALMA FAMILY CHILD CARE		FACILITY NUMBER:	376628323
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	05/30/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Alma Gonzalez		TIME COMPLETED:	03:35 PM

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Licensing Program Analysts (LPAs) Yolanda Baez and Elise Read conducted an announced pre-licensing site inspection for re-location with Applicant, Alma Gonzalez. Purpose of the inspection is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This 3 bedroom and 2 bathroom home was toured and inspected to ensure environment is safe for the care and supervision of children.

Applicant owns the home and has provided proof of occupancy by showing LPA her mortgage statement with the current address and Applicant's name. Applicant will use the following areas for child care: living room, hallway bathroom, bedroom #1, and fenced patio. The following areas are made inaccessible by the use of door knobs and safety gates: kitchen, dining room, second living room, master bedroom and bathroom, bedroom #2, and attached garage. There are no bodies of water observed during time of visit. The fire extinguisher is rated 2A 10B:C and is located in the kitchen area. The smoke and carbon monoxide detectors meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children through latches, locks, and are placed up on high surfaces.

Children’s toys and play equipment are available. Applicant stated that there are no firearms or ammunition in the home. Applicant has completed the 8 hours of preventative health training. Pediatric CPR and First Aid certifications expire on 10/2020. Required documents are posted. Applicant and all adults residing in the home have been cleared for criminal record and child abuse index clearances. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18^th birthday must be fingerprinted within 30 days. Immunization records per SB792 were reviewed and is in compliance. Applicant understands that all personnel who will be providing care and supervision to children must have immunization records present at the facility available for review.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda Baez	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019

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: GONZALEZ, ALMA FAMILY CHILD CARE	FACILITY NUMBER: 376628323
	VISIT DATE: 05/30/2019

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Per applicant operating hours are 6:30AM-5:30PM, Monday through Saturday. LPA Baez advised the Applicant that no changes should be made to the home without prior notice and/or approval from Licensing.

Incidental Medical Services (IMS) policy was discussed. 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

The New Provider Resource Packet was reviewed with the Applicant including information on the following: SIDS, shaken baby syndrome, New Safe Sleep Regulations, insurance, child abuse reporting, community resources, children’s records packet/facility records/required postings, immunization's (per SB792 and child immunizations), unusual incident report, roster, car seat law, visual form for ratio/capacity, prohibited items handout (walkers, exersaucers, jumpers, and bouncy seats), fire/disaster drill log. Applicant was also reminded that corporal punishment and smoking is not allowed in the day care.

Duty Line: (619) 767-2248, open Monday through Friday from 8AM to 5PM.
Child Advocates email: childcareadvocatesprogram@dss.ca.gov

A Small Family Child Care Home will be issued effective today.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda Baez	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019

LIC809 (FAS) - (06/04)

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