376628680-8-27-2021-20-CC-MHEZ-C6APVF-20210827113904

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628680
Report Date: 08/27/2021
Date Signed: 08/27/2021 11:39:08 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:	MENDOZA HERRERA, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	376628680
ADMINISTRATOR:	MARIA MENDOZA HERRERA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 386-5192
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92154
CAPACITY:	14	CENSUS: 3	DATE:	08/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Daniel Mendoza, Facility Representative		TIME COMPLETED:	11:40 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 August 27, 2021, at 10:30 AM, Licensing Program Analyst (LPA), Marie Hernandez conducted an unannounced Annual Required Inspection and met with the Adult Helper, Daniel Mendoza (Licensee's adult son). The Adult Helper stated the Licensee is not home at this time but will be back much later. However, LPA spoke to the Licensee via her cell phone number. Via phone, the Licensee assisted the Adult Helper with the inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Adult Helper. During the inspection, there are three children with the Adult Helper. This facility is a one story, four bedroom, and three bath home. The Adult Helper accompanied LPA inside and out of the facility during this inspection. The following areas are used for child care are: The kitchen, dining room, living room, day care room, downstairs bathroom and the backyard. The off limit areas are the entire upstairs, and downstairs bedroom. The off limits areas are inaccessible to the children during today's inspection. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. All hazardous items were inaccessible to children. The storage area for poisons is locked. The licensee has toys, play equipment and materials available. No bodies of water observed on the premises during the inspection. The Adult Helper 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 a criminal record and child abuse clearances or exemptions. Licensee’s First Aid and CPR certification expires on 08/2022 and the Adult Helper, Daniel's, first aid and CPR expires on 11/2022. Licensee and the Adult Helper have the required immunization's. The Mandated Reporter certification was reviewed and must be renewed every two years. The Licensee conducted the fire/disaster drill on 03/15/2021. Via phone, the Licensee stated she is not providing care for day care infants at this time. LPA discussed and provided the Safe Sleep handouts including the Individual Infant Sleeping Plan [LIC 9227 (3/20)]. LPA 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. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in day-care. Discussed the information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and the Adult Helper discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Marie Hernandez	TELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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: MENDOZA HERRERA, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 376628680
	VISIT DATE: 08/27/2021

NARRATIVE

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LPA discussed and provided 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.

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 deficiency cited today. An exit interview was conducted with the Adult Helper. Via phone, the Licensee gave consent for her Adult Helper (son) to sign and receive the report on her behalf. The Adult Helper was provided a copy of the report and the notice of site visit. LPA observed the Notice of Site Visit being posted at the facility.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Marie Hernandez	TELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC809 (FAS) - (06/04)

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