376628428-9-14-2021-20-CC-MHOD-C6UNNV-20210914103723

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628428
Report Date: 09/14/2021
Date Signed: 09/14/2021 10:37:34 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:	BRAVO LOPEZ, ANA & HERNANDEZ, HUGO FCC		FACILITY NUMBER:	376628428
ADMINISTRATOR:	ANA BRAVO & HUGO HERNANDEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 919-3737
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92114
CAPACITY:	14	CENSUS: 0	DATE:	09/14/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Ana Bravo & Hugo Hernandez, Licensees		TIME COMPLETED:	10:50 AM

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 09/14/2021 at 9:30 a.m., Licensing Program Analyst (LPA), Michelle Hood conducted an unannounced Annual Required Inspection and met with the Licensees. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Zero children were present in the facility during this inspection. The licensees accompanied LPA inside and out of the facility during this inspection. The following areas used for child care are living room, downstairs bedroom, bathroom, and yard. The off-limits areas are inaccessible through the use of safety gates. The fire extinguisher, smoke detector, and carbon monoxide detector met the requirements. All hazardous items were inaccessible to children. The storage area for poisons is locked. The licensees has toys, play equipment, and materials available. The home has a fenced backyard available for outdoor activities. No bodies of water were observed on the premises during the inspection. The living room fireplace is barricaded. The licensees 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. Licensee Ana Bravo's First Aid and CPR certifications expire on 04/2023. The licensee has required immunizations. Licensees completed Mandated Reporter Training. The facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 08/13/2021. Licensees stated they do not care for infants at this time. LPA and licensees reviewed the Individual Infant Sleeping Plan [LIC 9227 (3/20)]. 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.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (691) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

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: BRAVO LOPEZ, ANA & HERNANDEZ, HUGO FCC	FACILITY NUMBER: 376628428
	VISIT DATE: 09/14/2021

NARRATIVE

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

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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

No deficiencies cited

An exit interview was conducted with the licensees. The licensees was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

LPA provided LIC 9213 - Notice of Site Visit and observed it being posted at the facility.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Michelle Hood	TELEPHONE: (691) 767-2241
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

LIC809 (FAS) - (06/04)

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