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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100091
Report Date: 09/15/2021
Date Signed: 09/15/2021 04:18:46 PM

Document Has Been Signed on 09/15/2021 04:18 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:MENA, IDANIA & SUAREZ, FERNANDO FAMILY CHILD CAREFACILITY NUMBER:
376100091
ADMINISTRATOR:IDANIA MENA & FERNANDO SUAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 915-6093
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
09/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:IDANIA MENATIME COMPLETED:
04:35 PM
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On 9/15/21 at 1:05pm LPA Patrick Ma and Keturah Lane conducted an unannounced annual inspection with the Licensee. Upon arrival, LPAs met with Licensee Idania Mena. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present were the Licensee, adult son Cesar Gonzalez, and 3 day care children.

The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements and are operational. Licensee was reminded that hazardous items need to always be latched/locked and secured out of reach of children. The large detached fire place in the living room was screened. There is no body of water on the property. Licensee states that 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. First Aid and CPR certifications expired on 8/2021. Licensee has required immunizations. Licensee Idania’s Mandated Reporter Certificate expired on 7/26/21 and Co-Licensee Fernando Suarez expired on 4/8/21. Helper Cesar Gonzalez did not have Mandate Reporter Certificate on file. Children’s records were reviewed and found to be in order. Staff records need to be complete prior to working with children.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include living room, kitchen, hallway bathroom, bedroom 1, outdoor play area (fully fenced front, side, and back of the home). Off limits areas include garage, bedroom 2, bedroom 3 and Licensee was reminded that the door latch locks need to be locked to make the rooms inaccessible during day care hours. The licensee has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. At 1:32pm, LPAs observed screws protruding from the side of the fence in 2 areas of the front yard. LPAs advised Licensee to covers the screws. Licensee understands that supervision is required at all times during outdoor activities.
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2021
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: MENA, IDANIA & SUAREZ, FERNANDO FAMILY CHILD CARE
FACILITY NUMBER: 376100091
VISIT DATE: 09/15/2021
NARRATIVE
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Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. Licensee discussed 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. LPA Ma and LPA Lane reviewed Covid-19 guidelines with Licensee and Licensee had all Covid-19 safety information posted. LPA Ma directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.

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.

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.

See LIC809D for deficiencies cited.

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. LPA provided notice of site visit and observed it being posted at the facility. Notice of Site Visit must remain posted for 30 days.
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/15/2021 04:18 PM - It Cannot Be Edited


Created By: Patrick Ma On 09/15/2021 at 02:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MENA, IDANIA & SUAREZ, FERNANDO FAMILY CHILD CARE
FACILITY NUMBER: 376100091

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/15/2021
Section Cited
HSC
1596.8662

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1596.8662 ...a licensed child care provider...or employee of a licensed child day care facility shall complete the mandated reporter training. This
requirement was not met as evidenced by...
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Licensee stated she will ensure all adults providing care to children will complete their Mandated Reporter Training by 10/1/21 and send proof of completion via email to LPA Ma patrick.ma@dss.ca.gov.
www.mandatedreporterca.com
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Based upon record review and licensee statement Mandated Reporter Training was not renewed and helper did not complete training which poses a
potential Health, Safety, or Personal Rights
risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Renesha Pack
LICENSING EVALUATOR NAME:Patrick Ma
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2021


LIC809 (FAS) - (06/04)
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