376101546-12-12-2023-51-CC-PMAA-CYFQLF-20231212111553

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101546
Report Date: 12/12/2023
Date Signed: 12/12/2023 11:16:01 AM

Document Has Been Signed on 12/12/2023 11:16 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:	MONDRAGON, BEATRIZ FAMILY CHILD CARE		FACILITY NUMBER:	376101546
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 4	CENSUS: 4	DATE:	12/12/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Beatriz Mondragon		TIME COMPLETED:	11:45 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 12/12/23 at 9:30am Licensing Program Analyst (LPA) Patrick Ma conducted an unannounced inspection for an increase in capacity application. Licensee submitted application to the Department on 9/14/23. Fire clearance was completed 10/2023. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present in the home were 4 day care children, all under 24 months. 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, bedroom 2, both bathrooms, front and back yard. Off limit areas are the master bedroom and garage and is inaccessible through use of door locks. The licensee has sufficient toys and equipment available. The home has a fenced front and backyard available for outdoor activities. Licensee understands that supervision is required at all times during outdoor activities. The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There is no body of water on the property. Licensee states that there are no weapons in the home. First Aid and CPR certifications expire on 3/2024. Licensee has required immunizations. Licensee completed Mandated Reporter Training on 6/3/22 and is reminded it must be completed every 2 years. Children’s and Staff records were reviewed and found to be in order. Licensee provided proof of child care insurance. Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms; 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.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

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: MONDRAGON, BEATRIZ FAMILY CHILD CARE	FACILITY NUMBER: 376101546
	VISIT DATE: 12/12/2023

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed 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 and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed applicant 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.

The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). If capacity increase is approved, they can operate with a maximum capacity of 14 children.

Licensee is to be present in the home to ensure children are supervised and is reminded that the license is NOT transferable and should she relocate, this license will be null and void. Licensee was reminded that annual fees are due on the date they were licensee every year.

No deficiency cited.

The following correction is needed for increase capacity:
• Updated Preventative Health Certification with Lead Poisoning Prevention training

Applicant understands that corrections must be submitted to the Department within 30 days or the application may be denied.

Exit interview conducted and report was reviewed with the applicant Beatriz Mondragon. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

LIC809 (FAS) - (06/04)

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