376628570-11-17-2021-20-CC-DSAZ-C8UQ9B-20211117105803

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628570
Report Date: 11/17/2021
Date Signed: 11/17/2021 10:58:10 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:	MARTINEZ, ELVIA FAMILY CHILD CARE		FACILITY NUMBER:	376628570
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 7	DATE:	11/17/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Elvia Martinez, Provider		TIME COMPLETED:	11:00 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	Licensing Program Analyst (LPA) D. Sanchez made an unannounced Case Management inspection in response to the increase of capacity request. LPA was greeted and allowed entry into the facility by Elvia Martinez who was advised of the purpose of today’s inspection. This facility is two story, four bedroom, three bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. Daycare areas includes: Main Daycare room located in the very back of the home, open room next to the daycare room, bathroom located inside the main daycare room, kitchenette located inside the main daycare room, main kitchen, half bathroom, dining room, living room and backyard. Off limits areas includes: all areas in the second floor, and garage. Stairs are being remodel and provider will send photo showing the secure stairs when finished. The main daycare room will be the room located in the very back of the facility, which includes the bathroom, kitchenette and a side open room. The kitchenette has been barricaded with a wooden fence across wall to wall. Provider needs to secure the door of the wooden fence that leads to the kitchenette. The entrance to the daycare is thru the outside left gate that leads to the back entrance of the main daycare room. Children will also have access to the entire first floor of the house. LPA noticed that all required notices, License and forms were properly posted. The house smoke and carbon monoxide detectors are operable and fire extinguisher is fully charged. The day care bathroom was inspected; the toilet and faucets are operational. A review of all adults living in this home who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR are up to date. Provider stated that they do not have hand gun or ammunition in this house. Per new Senate Bill 792 pertaining to immunizations, which require all adults in daycare operation to have proof of immunizations for; Measles, Pertussis or Whooping Cough and Influenza or Flu, LPA has verified that licensee has verification of required immunizations and complies.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana Sanchez	TELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021

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: MARTINEZ, ELVIA FAMILY CHILD CARE	FACILITY NUMBER: 376628570
	VISIT DATE: 11/17/2021

NARRATIVE

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Assembly Bill 1207 Mandated Child Abuse Reporting. Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years.

LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
Community Care Licensing WEB SITE: http://www.ccld.ca.gov

LPA provided licensee with a copy of the SIDS Safe Sleep printout information, Safe Sleep Regulation Concepts and Lead Exposure brochure. LPA advised provider of the importance of child abuse reporting, children’s records, immunization, shaken baby syndrome and the YMCA Resource Center. LPA explained clearance requirements for persons over 18 residing or working in the facility. Provider understood that physical discipline/corporal punishment and smoking shall never be permitted in the child care program. Provider was also advised that exersaucers, bouncy, rockers, walkers shall never be permitted in the child care program.

The following items needs to be corrected and completed by December 1, 2021:

· Secured door in wooden fence that is being used to barricade kitchenette.
· Secured stairs when finished remodeling.

An exit interview was conducted with licensee and a copy of this report left at the facility.

LPA observed provider placing the Notice of Cite Visit on the wall visible to parents during today’s inspection.

NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana Sanchez	TELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021

LIC809 (FAS) - (06/04)

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