376629146-11-23-2021-20-CC-DSTS-C92VBY-20211123151820

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629146
Report Date: 11/23/2021
Date Signed: 11/23/2021 03:18:34 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:	AVILA, ANA FAMILY CHILD CARE		FACILITY NUMBER:	376629146
ADMINISTRATOR:	ANA AVILA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 862-0611
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	14	CENSUS:	DATE:	11/23/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Ana Avila		TIME COMPLETED:	03:30 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 11/23/2021 at 1:30 PM, Licensing Program Analyst (LPA) Dana Stevens conducted an announced pre-licensing inspection with applicant, Ana Avila. The applicant's daughter, Michelle Posada, assisted with translating in Spanish. Purpose of the inspection is Change of Location. This single story, four bedroom, two bath home was inspected to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. Applicant will use the following areas for child care: living room, Kitchen, dining area, and hall bathroom. Off limits areas include: All bedrooms, laundry room, office, garage and side yard. They are made inaccessible to day care children through the use of door locks, doorknob covers, and safety gates. Applicant will utilize the backyard and front yard for outdoor activities both are fully fenced. Front yard has a trampoline and applicant understands that total supervision is required during outdoor play.The fireplace is screened. The fire extinguisher is rated 3A 40B:C and is located in the living room. Smoke and carbon monoxide detectors meet requirements and are operational. All poisons, detergents, cleaning compounds, and medicines are inaccessible to children in care and are located in off limit areas with cupboard latches and door locks and secured out of reach of children. Children’s toys and play equipment are available. The applicant has a working telephone/cell phone. Applicant indicated there are no firearms or other weapons in the home. Applicant maintains documentation of proof of control of property for review by the Department. Applicant completed Mandated Reporter AB1207 training certification and 8 hours of preventative health. Pediatric CPR and First Aid certifications expire on 09/2022. Required documents are posted. Applicant and adult residents in the home have criminal record clearances and/or exemptions on file.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana Stevens	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021

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: AVILA, ANA FAMILY CHILD CARE	FACILITY NUMBER: 376629146
	VISIT DATE: 11/23/2021

NARRATIVE

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LPA advised that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. Applicant states they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes. The hours of operation are Monday through Sunday, 24 hours a day.

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

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.

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.

A Regular Small Family Child Care Home license maybe issued upon final file review. Applicant's daughter interpreted and explained inspection report to applicant in Spanish, applicant stated she understood. An exit interview was conducted and a copy of the report was provided to the applicant.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Dana Stevens	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 11/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021

LIC809 (FAS) - (06/04)

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