376628656-10-14-2021-20-CC-CGUY-C7SQD5-20211014120409

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628656
Report Date: 10/14/2021
Date Signed: 10/14/2021 12:04:17 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:	ESPARZA, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	376628656
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	10/14/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Maria Esparza		TIME COMPLETED:	12:15 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	On 10/14/2021 at 10:45 a.m., Licensing Program Analyst (LPA) Casey Gulley conducted an unannounced case management inspection for the purpose of a capacity increase with the licensee. The three bedrooms, four bathroom home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire clearance was granted on 10/04/2021. The fire extinguisher, carbon monoxide detector , and smoke detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water on the property. Licensee states that 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. First Aid and CPR certifications expire on October 2022. Licensee meets immunizations requirements and Mandated Reporter Training AB 1207 was completed on 6/19/2020. Applicant will be using the following rooms for childcare: living room, dining room, kitchen and bathroom #1 The following areas will be off limits: all bedrooms and outdoor studio. The applicant has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. The following information was reviewed with the applicant: information on reporting requirements for suspected child abuse and unusual incidents, children’s records, immunizations, adults living or working in the home and related civil penalties, shaken baby syndrome, Safe Sleep Regulation/SIDS, and Lead Exposure. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers 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.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Casey Gulley	TELEPHONE: (619) 767-2216
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: ESPARZA, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 376628656
	VISIT DATE: 10/14/2021

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LPA discussed and provided licensee with the following: Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov and phone number (916) 654-1541.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 deficiencies are cited. No corrections are needed; a license for 14 will be issued effective today, 10/14/21.

The licensee 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 notice of site visit and observed it being posted at the facility.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Casey Gulley	TELEPHONE: (619) 767-2216
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

LIC809 (FAS) - (06/04)

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