376629066-4-27-2021-20-CC-CGUY-C2GS8C-20210427133855

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629066
Report Date: 04/27/2021
Date Signed: 04/27/2021 01:41:02 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:	GASTELUM, LAURA FAMILY CHILD CARE		FACILITY NUMBER:	376629066
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	04/27/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Laura Gastelum		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	Licensing Program Analyst (LPA) Casey Gulley conducted an unannounced case management inspection for the purpose of a capacity increase with the licensee via FaceTime. The 4 bedroom, 3 bathroom home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire clearance was granted on 4/19/21. The fire extinguisher, carbon monoxide detector, and smoke detector located in kitchen and 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 2/2023. Licensee meets immunizations requirements and Mandated Reporter Training AB 1207 was completed on 3/25/2020. Applicant will be using the following rooms for childcare living room, dining room and kitchen: The following areas will be off limits: entire upstairs and garage 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: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: GASTELUM, LAURA FAMILY CHILD CARE	FACILITY NUMBER: 376629066
	VISIT DATE: 04/27/2021

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
26
27
28
29
30
31
32

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 4/28/21.

A copy of the report will be e-mailed to applicant and acknowledgement of the receipt of the report is to be received within twenty-four hours.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Casey Gulley	TELEPHONE: (619) 767-2216
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2