<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610597
Report Date: 03/25/2024
Date Signed: 03/25/2024 01:30:14 PM

Document Has Been Signed on 03/25/2024 01:30 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:OSUNA, JACQUELINE FAMILY CHILD CAREFACILITY NUMBER:
136610597
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
03/25/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Jacqueline OsunaTIME 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 March 25, 2024, at 8:45 AM, Licensing Program Analyst (LPA) JoAnn Legaspi conducted an unannounced Annual Random Inspection, room addition inspection and capacity increase inspection. LPA met with the Licensee Jacqueline Osuna. LPA disclosed the purpose of the inspection and was granted facility entry by the Licensee. The Licensee, her background cleared adult daughter and two (2) children were present in the facility during this inspection.

On 01/08/2024, the Licensee submitted an application (LIC 279) requesting a capacity increase. The Licensee has at least one year of experience as a regulated small family childcare home operator. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal on 01/22/2024 for fourteen (14) children. Landlord Consent is on file. The Licensee would also like to add a previously off limit bedroom for use.

Licensee accompanied LPA during this inspection. This one (1) story, three (3) bedroom, two (2) bathroom house was toured and inspected. The following areas are used for childcare: living room, dining room, one bedroom, hallway bathroom, kitchen, family room and the fenced backyard. The off-limit area includes two (2) bedrooms and one (1) bathroom. These rooms are made inaccessible by use of safety latches and key doorknobs. Inspection of the proposed bedroom was completed and saw it met regulatory requirements.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. Hazardous items were observed to be inaccessible to children during this inspection. The Licensee has available toys, play equipment and materials. Licensee states children engage in outdoor activities in the fenced backyard. Licensee was reminded that continuous supervision is to be given to children whenever engaged in outdoor activities. No bodies of water were observed on the premises during the inspection. Firearms are appropriately stored as required by regulation. A small dog is in the home but kept in an off limit room when daycare children are present.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/25/2024
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 4
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: OSUNA, JACQUELINE FAMILY CHILD CARE
FACILITY NUMBER: 136610597
VISIT DATE: 03/25/2024
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
Licensee’s First Aid and CPR certifications expire in August 2024. Licensee was reminded to renew their First Aide and CPR certifications and obtain their certification card before August 2024. Licensee has required immunizations. Mandated Reporter Training was completed and expires in September 2024. Licensee was reminded to retake the Mandated Reporter Training and obtain its training completion certificate before September 2024. The facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 3/20/2024.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

The Licensee was provided with the Ratio/Capacity Worksheet for a large family childcare home. The Licensee recognizes that the total amount of children simultaneously in the home also includes children who reside in the home. The Licensee acknowledged that if no assistant provider is present at a Large Family Child Care Home, then the Licensee shall comply with the capacity requirements for a Small Family Child Care Home.

Licensees of family day care homes shall ensure that at least one staff member shall always be onsite when children are present at the facility and shall be present with the children when children are offsite from the facility for facility activities. The Licensee shall ensure at least one staff member has a current course completion card in pediatric first aid and pediatric CPR issued by the American Red Cross, the American Heart Association, or by a training program that has been approved by the Emergency Medical Services Authority. Prior to employment or initial presence in the childcare home, all employees subject to a criminal record review shall: obtain a California clearance or a criminal record exemption as required by law or Department regulations or request a transfer of a criminal record clearance. The Licensee shall not employ a staff member if they have not been immunized against influenza, pertussis, and measles. Each employee shall receive an influenza vaccination between August 1 and December 1 of each year. The employee may submit a yearly written declaration attesting that they have declined the influenza vaccination. This exemption applies only to the influenza vaccine. Documentation of immunizations is to be maintained in the staff’s
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: OSUNA, JACQUELINE FAMILY CHILD CARE
FACILITY NUMBER: 136610597
VISIT DATE: 03/25/2024
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
facility personnel record. The Licensee shall provide each employee with a copy of the Notice of Employee Rights (LIC 9052 (4/88)) form furnished by the Department. Each employee shall be requested to sign and date the notice form acknowledging receipt. A copy of the signed notice form shall be retained in the employee's personnel record. If the employee refuses to sign the notice form, a dated notation to that effect shall be retained in the employee's personnel record.

On this date, 03/06/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ. During the exit interview, the Licensee Osuna, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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 provided Licensee with Provider Information Notice (PIN) 20-24-CCP, a blank LIC 9227 “Individual Infant Sleeping Plan” form and one (1) example of a safe sleep log.

LPA reviewed with licensee the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the licensee. LPA reminded Licensee of 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.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: OSUNA, JACQUELINE FAMILY CHILD CARE
FACILITY NUMBER: 136610597
VISIT DATE: 03/25/2024
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
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. The Licensee’s email address is already enrolled in this email platform.

In the areas that were evaluated, no deficiencies were observed. The previously off limit bedroom is now approved for use. Licensure for a capacity of fourteen (14) of children is approved today (3/25/2024). A new license will be generated and mailed to the provider.

A notice of site visit was given to the licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the Licensee Jacqueline Osuna.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4