376628428-9-24-2019-20-CC-ERED-BGBUDX-20190924153015

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628428
Report Date: 09/24/2019
Date Signed: 09/24/2019 03:30:22 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:	BRAVO LOPEZ, ANA & HERNANDEZ, HUGO FCC		FACILITY NUMBER:	376628428
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	09/24/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:55 PM
MET WITH:	Ana Bravo Lopez and Hugo Hernandez		TIME COMPLETED:	03:45 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) Elise Read conducted an announced Pre-Licensing inspection with the applicant. The home was toured and inspected to ensure an environment safe for the care and supervision of children. Applicant states that operating hours are 7 days per week, 24 hours per day. The fire extinguisher, carbon monoxide detector (located in the hallway), and smoke detector (located in the hallway) meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water in the home. Applicant states that there are no weapons in the home. Applicant states that they have sufficient financial resources to sustain the license. 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. Applicant rents the home and has provided the Landlord Notification Form. First Aid and CPR for Ana expire on 03/2021. First Aid and CPR for Hugo expire on 08/2021. Ana completed preventative health practices course on 09/10/2017. Hugo completed preventative health practices course on 09/08/2019. Mandated Reporter Training AB 1207 was completed on 09/01/2019 for Hugo and 09/09/2018 for Ana. Staff immunization requirements per SB792 were met. Applicant will be using the following rooms for childcare: living room, hallway bathroom, office, and down stairs bedroom. The following areas will be off limits: entire upstairs, which is kept inaccessible through the use of a safety gate. The garage will also be off limits and is kept inaccessible through the use of a door knob cover. The fireplace is screened. The applicant has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2232
LICENSING EVALUATOR NAME: Elise Read	TELEPHONE: (619) 767-2240
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

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: BRAVO LOPEZ, ANA & HERNANDEZ, HUGO FCC	FACILITY NUMBER: 376628428
	VISIT DATE: 09/24/2019

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 new provider packet was reviewed with the applicant including information on child abuse reporting, children’s records, immunizations, adults living or working in the home, car seat law, shaken baby syndrome, SIDS and safe sleep, effects of lead poisoning, Incidental Medical Services, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed the following with applicant or Licensee: maximum capacity for a small family child care home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home.

LPA discussed and provided applicant with the following: Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov. In addition, for common questions or questions regarding licensing requirements to 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.

No corrections are needed. A license for 8 children may be issued upon final file review.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2232
LICENSING EVALUATOR NAME: Elise Read	TELEPHONE: (619) 767-2240
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2