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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101566
Report Date: 08/02/2023
Date Signed: 08/02/2023 12:02:12 PM

Document Has Been Signed on 08/02/2023 12:02 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LOPEZ, JUDITH & MAGDALENA FCCHFACILITY NUMBER:
376101566
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 0DATE:
08/02/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Judith LopezTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA), Saraliz Velando, conducted an announced Prelicensing Inspection for a change of location. LPA was greeted at the front door by licensee, Judith Lopez. LPA was granted entry after identifying herself and disclosing the purpose of her visit. Licensee is using the following areas for daycare: Living room, Dining room, Kitchen, Bedroom 1, and Bathroom 1. There is a garage attached to the home. Off-limits areas will be: Bedrooms 2,3,4, Bathroom 2, Laundry room, Garage, Front yard, and Back yard. The children are provided a safe, healthful, and comfortable environment, furnishings, and equipment. Business Hours will be Monday- Saturday, 5:00am-3:00am.

LPA tested the smoke alarm located in Bedroom 3 and the carbon monoxide detector located in the hallway area, they are both functional. There is a fire extinguisher in the living room area that meets regulations. LPA did not observe any bodies of water on the premises. Licensee stated there are no weapons or ammunition stored on the premises and LPA did not observe any.

There is no fireplace in the home or open wall heaters. Storage for poisons, detergents, cleaning solutions, medications are out of reach in off limit areas and inaccessible to children by latches and safety locks. Outdoor play will take place at a nearby park with constant supervision. The home is kept clean and orderly with heating and ventilation for safety and comfort. Pediatric CPR and First Aid card will expire February 2024. Mandated Reporter Training expires May 2024. Licensee has a Letter of Declination for flu shot on file. There is a working telephone and email address.

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.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2023
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: LOPEZ, JUDITH & MAGDALENA FCCH
FACILITY NUMBER: 376101566
VISIT DATE: 08/02/2023
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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.

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.

LPA completed the RSO profile in FAS.

The following items will need to be corrected prior to the issuance of the license: One crib or pack and play for infant. Once the corrections have been made, and proof has been received in the licensing office, a license for eight (8) children will be granted. Licensee also understands that if the correction is not completed within thirty (30) days, application may be denied. Applicant agreed to comply with all regulations and laws governing Family Child Care Homes.

Exit interview conducted and report was reviewed with the licensee Judith Lopez.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023
LIC809 (FAS) - (06/04)
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