376629087-4-18-2022-20-CC-RGOU-CDLQUT-20220418122915

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629087
Report Date: 04/18/2022
Date Signed: 04/18/2022 12:29:24 PM

Document Has Been Signed on 04/18/2022 12:29 PM - It Cannot Be Edited

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:	GALVEZ, MICHELE FAMILY CHILDCARE		FACILITY NUMBER:	376629087
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 7	DATE:	04/18/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Michele Galvez		TIME COMPLETED:	12:45 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 04/18/22 at 9:30 a.m., Licensing Program Analyst (LPA), Rajani Goudreau conducted an unannounced annual and capacity increase Inspection and met with the Licensee, Michele Galvez. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. There were seven children in care (including: one infant, two school age and four preschool age children). In addition, licensees’ 14-year-old daughter was present in the home. This facility is a one story, three-bedroom, one-bathroom home. The following areas are used for childcare: living room, dining room, bathroom located in the hallway of home and backyard. The following off-limit areas are made securely inaccessible: three-bedrooms, front yard and garage. Operation hours are Monday through Sunday, 24 hours. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements, per LPA observation. LPA observed hazardous items inaccessible to children in care. LPA informed licensee poisons shall be placed in a storage area and locked. LPA observed toys, play equipment and materials available for the children’s use. The home has a backyard available for outdoor activities. LPA informed licensee children shall be supervised during outdoor activities. No bodies of water observed on the premises during the inspection. In addition, Licensee confirmed there are no bodies of water on the premises of the property. 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 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Licensee’s First Aid and CPR certifications are valid and expire in May 2022. Licensee has required immunization's on file, per file review. Licensee has completed the Mandated Reporter Training in June 2020. LPA informed the licensee the Mandated Reporter training shall be completed once every two years. The facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on August 2021. See LIC809-C continuation page...

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

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: GALVEZ, MICHELE FAMILY CHILDCARE	FACILITY NUMBER: 376629087
	VISIT DATE: 04/18/2022

NARRATIVE

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There is play yard for each infant who is unable to climb out of the play yard. Play yards are free from all loose articles and objects. The provider physically checks on sleeping infants every 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, per licensee.

Fire clearance was granted on April 12, 2022 with the condition the garage is not used for additional daycare space and is not converted into a living space.

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.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . LPA informed licensee in order to sign up for Quarterly Updates and PINs through our website. Please go to www.cdss.ca.gov and on the right side of your screen click on “Receive Important Updates”, put your email address in and choose which program(s) you would like to subscribe to and click “subscribe. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248. See LIC809-C continuation page.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

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: GALVEZ, MICHELE FAMILY CHILDCARE	FACILITY NUMBER: 376629087
	VISIT DATE: 04/18/2022

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

LPA discussed the following with Licensee: Max capacity when there is an assistant present: 12 children-no more than 4 infants (birth to 24 months). When caring for 14 children no more than 3 infants. 1 child in kindergarten and 1 child at least 6 years old. When there is no qualified assistant the capacity reverts back to the requirements from a small child care. You must notify the parents of the children in care when caring for more than 12 children. Licensee acknowledged understanding of the capacity and ratio requirements for a large license. Large visual ratio handout provided to licensee.

No deficiencies issued during today's visit. One Technical Violation Advisory Note Issued. The following licensing reports reviewed with Licensee: LIC809 reports, Appeal Rights-LIC9058, Notice of Site Visit - LIC9213. A large license for 14 children shall be granted after final file review. Once the license is issued, the license will be mailed to the licensee and shall be posted in a prominent location in the home. A notice of site visit was provided and must remain posted for 30 days from today’s date. Exit interview conducted with Licensee, Michele Galvez.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

LIC809 (FAS) - (06/04)

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