376629226-12-14-2021-20-CC-GGOZ-C9PQC7-20211214110240

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629226
Report Date: 12/14/2021
Date Signed: 12/14/2021 11:02:51 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:	MARTINEZ, TERESA FAMILY CHILD CARE		FACILITY NUMBER:	376629226
ADMINISTRATOR:	TERESA MARTINEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 581-8805
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92104
CAPACITY:	14	CENSUS: 0	DATE:	12/14/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Teresa (Veronica) Martinez		TIME COMPLETED:	11:15 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 December 14, 2021 at 9:00 AM, Licensing Program Analyst (LPA) Gloria Gonzalez conducted an announced prelicensing inspection with applicant, Teresa (Veronica) Martinez for the purpose of a change of location. LPA disclosed the purpose of the inspection and was granted a tour into the facility by the Applicant. Purpose of the inspection is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This one story, three bedroom, two bath home was toured and inspected. The hours of operation are Monday through Friday, 8:00 a.m. to 6:00 p.m. Applicant will use the following areas for child care: living room, dining room, bathroom 1&2, bedrom/naproom, kitchen, backyard, and patio/sunroom. Off limits areas include: bedroom/office, garage, and bedroom. They are made inaccessible to day care children through the use of doorknob covers. Applicant will utilize the patio and backyard for outdoor activities. The fireplace is screened. The wall heaters are not screened. LPA did not observe any bodies of water during time of inspection. The fire extinguisher is rated 2A 10B:C and is located in the dining room, smoke and carbon monoxide detectors meet requirements and are operational. Applicant states poisons, detergents, cleaning compounds, and medicines are inaccessible to children in care and are located in off limit areas with cupboard latches 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. The Department received a Fire clearance on 11/9/21 for a Large FCCH. Applicant has completed the Mandated Reporter AB1207 training certification on 9/12/20. Applicant has completed the Preventative Health Training. Pediatric CPR and First Aid certifications expire on 6/11/23. Applicant and adult residents in the home have criminal record clearances on file. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. 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.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria Gonzalez	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021

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: MARTINEZ, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 376629226
	VISIT DATE: 12/14/2021

NARRATIVE

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LPA discussed when infants are in care there is to be one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. The applicant shall physically check on sleeping infants up to 24 months of age every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is to be maintained for each infant up to 12 months of age. The applicant understands to place infants up to 12 months of age on their backs for sleeping.

Applicant does not plan on providing Incidental Medical Services (IMS) to clients at this time. 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

The New Provider Resource Packet was reviewed with the applicant including information on the following: Safe Sleep, Lead Exposure, SIDS, shaken baby, child abuse reporting, community resources, children’s records, facility records, required postings, immunizations, unusual incident report, facility roster, car seat law, visual for ratio/capacity, fire/disaster drill log and discussed California Megan's Law and LPA provided the following: www.meganslaw.ca.gov. Applicant was also informed the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). LPA conducted technical support to provide applicant information regarding the COVID-19 disease. Corporal punishment and smoking are not allowed in the day care.

Please visit the Guardian web page and set-up your Guardian account. https://cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian
If you have any questions regarding Guardian, please contact CDSS at email: guardian@dss.ca.gov

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, with landlord consent (LIC 9149).

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria Gonzalez	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021

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: MARTINEZ, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 376629226
	VISIT DATE: 12/14/2021

NARRATIVE

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Applicant is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information.

Duty Line was provided: (619) 767-2248.

Southern California Child Care Advocate information was provided and applicant was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

The following corrections are needed prior to the issuance of the license:

Three wall heaters shall be made inaccessible to children by 12/31/21.

Once correction has been made a Regular Large Family Child Care Home license may be issued upon final file review.

An exit interview was conducted with the applicant, Teresa (Veronica) Martinez. The applicant was provided a copy of their appeal rights (LIC 9058 12/15).

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria Gonzalez	TELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021

LIC809 (FAS) - (06/04)

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