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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300580
Report Date: 07/29/2022
Date Signed: 07/29/2022 03:25:51 PM

Document Has Been Signed on 07/29/2022 03:25 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:FIGUEROA FAMILY CHILD CAREFACILITY NUMBER:
336300580
ADMINISTRATOR:FIGUEROA, ABIATAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 250-2119
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY: 14TOTAL ENROLLED CHILDREN: 1CENSUS: 1DATE:
07/29/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Abiata FigueroaTIME COMPLETED:
09:10 AM
NARRATIVE
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On date and time listed, Licensing Program Analyst (LPA) James Wilkerson arrived at the facility to conduct a pre-licensing inspection. Present during this inspection were: Abiata Figueroa, Francisco Zamudio & visitor, Yadira Flores. LPA toured the facility, inside and out and the following was observed and/or discussed: LPAs will need to access the facility through the front left side gate where a doorbell will be installed.

Normal days and hours of operation are: Monday through Friday, 8:00 am to 3:00 pm

OFF-LIMIT AREAS INCLUDE: Living Room, Kitchen and 2nd Floor

· Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the applicant during this inspection. Fire extinguisher, smoke detector and carbon monoxide detector are in working order.


· All hazardous items inaccessible
· Toxins locked
· No guns or weapons present as of this date. Applicant understands all guns, weapons and ammunition must be key-locked separately and made inaccessible per Title 22 Regulations.
· Stairs are barricaded from the day care area with a barricade leading to the living room where the stairs are located
.· The fireplace is properly screened
· Storage of poisons is inaccessible to children and locked
· Verification of control of property on file (viewed Loan Statement)
· Facility Sketch and Emergency Disaster Plan are posted
· Pediatric CPR and First Aid Card - expires 04/24/2023
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: James Wilkerson
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2022
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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: FIGUEROA FAMILY CHILD CARE
FACILITY NUMBER: 336300580
VISIT DATE: 07/29/2022
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· Health & Safety Certificate - completed on 07/24/2022
· There is an in-ground swimming pool/jacuzzi that has a five foot mesh fence with a self-closing, self-latching gate that opens away from the pool area. The mesh fencing is secured to a cemented ground with no room on the bottom of the fencing and the cemented area. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position when not in use.
· Clean, safe and age appropriate toys
· There are no toxic plants observed at this time
· The Applicant was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov, and UnusualIncidentReportsDO10@dss.ca.gov
· Issued applicant the following: SIDS information and Shaken Baby Syndrome pamphlet – For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx

Applicant, Abiata Figueroa was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 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 applicant, Abiata Figueroa 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 [applicant, licensee, or facility representative] 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.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: James Wilkerson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022
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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: FIGUEROA FAMILY CHILD CARE
FACILITY NUMBER: 336300580
VISIT DATE: 07/29/2022
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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: http://www.ada.gov/childqanda.htm

Per applicant, Abiata Figueroa there are no registered sex offenders living in or using the home address.

Exit interview conducted and report was reviewed with the applicant, Abiata Figueroa.

LPA reviewed with applicant, Abiata Figueroa 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 applicant.

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 platform.

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.

A fire clearance was granted for 14 ambulatory children for the facility on 07/12/2022. Per the fire clearance, the 2nd floor is not to be use for care.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: James Wilkerson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022
LIC809 (FAS) - (06/04)
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