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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610536
Report Date: 11/17/2022
Date Signed: 11/17/2022 12:18:56 PM

Document Has Been Signed on 11/17/2022 12:18 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:GONZALEZ, MELISSA FAMILY CHILD CAREFACILITY NUMBER:
136610536
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 0DATE:
11/17/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Melissa GonzalezTIME COMPLETED:
12:30 PM
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On November 17, 2020, at 11:15 a.m., Licensing Program Analysts (LPAs), Gloria Gonzalez and Julissa Valle conducted an unannounced case management inspection for the purpose of a capacity increase and met with the Licensee, Melissa Gonzalez.  LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee.  Licensee accompanied LPA inside and out of the facility during this inspection. The fire clearance for 14 children was received on 10/27/22. No daycare children and no staff were present in the facility during this inspection.  Licensee and assistant meet immunizations requirements. This facility is a 2 story, 4 bedroom, 2 bathroom house. Licensee accompanied LPAs inside and out of the facility during this inspection. The following areas used for childcare are: 1st living room, dining room, kitchen, tv room, bathroom #1, and backyard.  Off limits areas are all of upstairs (bedrooms #2, #3, #4, bathroom #2) garage, and laundry room and are inaccessible through use of door knob covers and a safety gate.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements.  All hazardous items were inaccessible to children. The licensee has toys, play equipment and materials available.  The home has a fenced backyard available for outdoor activities.  LPA did not observe any bodies of water. 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’s First Aid and CPR certifications expire on 2/2024.  Licensee has required immunizations.  Licensee completed Mandated Reporter Training on 4/14/22. 3 of 4 children’s records were reviewed and contain immunization documentation and Notification of Parent’s Rights form.

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.  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.  LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. 
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2022
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: GONZALEZ, MELISSA FAMILY CHILD CARE
FACILITY NUMBER: 136610536
VISIT DATE: 11/17/2022
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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 and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, 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, with landlord consent (LIC 9149).

Incidental Medical services (IMS) policy was discussed.  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.

A Large Family Child Care Home license may be issued upon final file review. LPA Gloria Gonzalez interpreted and explained inspection report to Licensee, Licensee stated she understood.

An exit interview was conducted with Licensee, Melissa Gonzalez.  The licensee was provided a copy of their report and appeal rights (LIC 9058). 

LPA provided notice of site visit and observed it being posted at the facility.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022
LIC809 (FAS) - (06/04)
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