376628667-7-9-2021-20-CC-JARL-C4RT5L-20210709142544

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628667
Report Date: 07/09/2021
Date Signed: 07/09/2021 02:25:58 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:	IBARRA, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	376628667
ADMINISTRATOR:	MARIA IBARRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(442) 258-9028
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY:	14	CENSUS: 10	DATE:	07/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:28 AM
MET WITH:	Maria Ibarra		TIME COMPLETED:	12:50 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 July 9^th, 2021 at 11:28 AM, Licensing Program Analyst (LPA), Jo Ann Legaspi conducted an unannounced Annual Required Inspection and met with the Licensee Maria Ibarra. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Language Link Operators 13824 and 13754 provided translation services. Ten (10) children, the Licensee and one (1) helper were present during the inspection. This facility is a one story, two bedroom, two bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas are used for care: living room, kitchen, two (2) bedrooms, two (2) bathrooms and backyard. The off limits areas are all made inaccessible via safety gates and cabinet locks. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. Hazardous items were inaccessible to children during this inspection. The Licensee has available toys, play equipment and materials. The home has a fenced backyard for play. Licensee was reminded that continuous supervision is to be given to children whenever engaged in outdoor activities. No bodies of water were observed on the premises during the inspection. Licensee 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’s First Aid and CPR certifications expire in April 2023. Licensee has required immunizations. Licensee completed Mandated Reporter Training on 01/28/2021. The facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 06/04/2021. There is one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. The Provider physically checks on sleeping infants every fifteen (15) minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age. The Provider places infants up to 12 months of age on their backs for sleeping.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

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: IBARRA, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 376628667
	VISIT DATE: 07/09/2021

NARRATIVE

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LPA discussed with the Licensee 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. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. LPA provided Licensee with written information about Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome and California Megan's Law. The website address to California Megan’s Law is: www.meganslaw.ca.gov. LPA discussed and provided Licensee with written information about the Child Care Advocate Program. The email address to the Child Care Advocate is: childcareadvocatesprogram@dss.ca.gov . Additionally, for general questions or questions regarding licensing requirements the Licensee was advised 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 cited.

An exit interview was conducted with the Licensee. The Licensee was provided a copy of their Licensee/Appeal Rights (LIC 9058 1/16) and their signature on this form acknowledges receipt of these rights.

LPA provided the Licensee with the Notice of Site Visit (LIC 9213 01/04). Licensee agreed to post this document for public viewing.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R Legaspi	TELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

LIC809 (FAS) - (06/04)

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