376629021-3-16-2021-20-CC-DSTS-BZ6VTK-20210316164317

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629021
Report Date: 03/16/2021
Date Signed: 03/16/2021 04:44:18 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:	BERMUDEZ, ERIKA FAMILY CHILD CARE		FACILITY NUMBER:	376629021
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS:	DATE:	03/16/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	03:26 PM
MET WITH:	Erika Bermudez		TIME COMPLETED:	04:15 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 March 16, 2021 at 3:30 PM, Licensing Program Analyst (LPA) Dana Stevens conducted a case management tele-inspection for the purpose of an increase in capacity via video conference (ZOOM), due to the Covid-19 outbreak. LPA met with Licensee Erika Bermudez. Licensee's assistant, who is fingerprint cleared was also present with 4 day care children. LPA conducted a live video tour of the inside and outside of this two story, five bedroom, 4 1/2 bath home. Applicant will use the following areas for childcare: Entire downstairs which includes Living room, Family room, TV room, one bedroom, 2 half bathrooms, dining area and kitchen. Off limits areas include: Entire upstairs (4 Bdrm/3 Bath) and garage. They are made inaccessible to day care children through the use of door lock and a safety gate at the bottom of the stairs. Applicant will utilize the backyard for outdoor activities The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. The licensee has toys, play equipment and materials available for children’s use. Licensee stated there are no bodies of water on the premises.The applicant has a working telephone/cell phone. Applicant indicated there are no firearms or other 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 on 08/2021. Licensee has required immunization. Licensee completed the Mandated Reporter Training. Children’s records were reviewed and found complete. The fire clearance for 14 children was granted/received on 03/05/2021. 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.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Dana Stevens	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2021

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: BERMUDEZ, ERIKA FAMILY CHILD CARE	FACILITY NUMBER: 376629021
	VISIT DATE: 03/16/2021

NARRATIVE

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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. For general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

LPA discussed the maximum number of children for whom care shall be provided when there is an assistant provider in the home, including children under age 10 who live in the licensee's home and the assistant provider's children under age 10, shall be either: Twelve (12) children with no more than four of whom may be infants or Fourteen (14) children, with at least two of the children with 1 child enrolled in kindergarten and 1 child at least six years of age and no more than three infants.

Licensee stated that Incident Medical Services are not being provided at this time. 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. No corrections are needed. A large license will be granted effective 03/16/2021.

A copy of the report and appeal rights (LIC 9058) will be e-mailed to the licensee and licensee was advised that acknowledgement of the receipts of the report and appeal rights are to be received within twenty-four hours

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Dana Stevens	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2021

LIC809 (FAS) - (06/04)

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