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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100817
Report Date: 08/20/2021
Date Signed: 08/20/2021 09:36:57 AM

Document Has Been Signed on 08/20/2021 09:36 AM - 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:GONZALES, ARCELY & REYCASA, MONIQUE FCCFACILITY NUMBER:
376100817
ADMINISTRATOR:ARCELY G. & MONIQUE R.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 793-7337
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
08/20/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Arcely and Monique TIME COMPLETED:
09:40 AM
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On 8/20/21 at 8:30 AM, Licensing Program Analyst (LPA) Annette Sutherland, conducted an announced Pre-Licensing inspection with the applicants. Upon arrival, LPA met with applicant Monique and co -applicant Arcely Gonzales. The one-story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher, carbon monoxide detector and smoke detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water in the home. Applicant states that there are no weapons in the home. Applicant states that they have sufficient financial resources to sustain the license. 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. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18th birthday must be fingerprinted within 30 days. Applicant rents the home. First Aid and CPR expire on June 16th, 2022 for Aracely, Monique is currently enrolled in a First Aid Recertification course. Preventative health practices course was completed on 7/25/21 for both Monique and Arcely which includes lead poison prevention training. Mandated Reporter Training was taken by Monique on 7/8/21 and Aracely on 10/3/2019. Staff immunization requirements were met. Required documents have been posted. The applicant has toys and equipment available.

Applicant will be using the following rooms for childcare: Living room, Dining room, Bedroom #1, Bathroom #1 and back yard. The following areas will be off limits: Bedroom #2 , bedroom #3, bathroom #2, kitchen and garage. The home has a back yard to be used for outdoor activities. Applicant understands that visual supervision is always required during outdoor activities.

(continued LIC809-C...)
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 08/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/20/2021
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: GONZALES, ARCELY & REYCASA, MONIQUE FCC
FACILITY NUMBER: 376100817
VISIT DATE: 08/20/2021
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The new provider packet was reviewed with the applicant including information on child abuse reporting and unusual incidents, children’s records, immunizations, adults living or working in the home and related civil penalties, SIDS/Safe Sleep Regulations, Incidental Medical Services, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and applicants discussed Shaken Baby Syndrome and California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA Sutherland reviewed COVID-19 guidelines with Applicant and provided COVID-19 resources. LPA Sutherland directed Applicant to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.

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.


No corrections are needed. A provisional license for 14 children will be granted effective today. Applicants understand that Monique Reycasa must submit proof of completion of first aid and CPR courses within 90 days or the license will expire.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2021
LIC809 (FAS) - (06/04)
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