376101735-3-15-2024-51-CC-KLAE-D3DQ8Z-20240315115735

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101735
Report Date: 03/15/2024
Date Signed: 03/15/2024 11:57:52 AM

Document Has Been Signed on 03/15/2024 11:57 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	TIBO, MARIEWS FAMILY CHILD CARE		FACILITY NUMBER:	376101735
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	03/15/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Mariews Tibo		TIME COMPLETED:	12:15 PM

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 3/15/24 at 9:00 AM, Licensing Program Analysts (LPAs) Keturah Lane and Victoria Hernandez, conducted an announced Pre-Licensing inspection for the applicant. Upon arrival, LPAs met with applicant Mariews Tibo and also present were applicant’s mother Vivian Elias and applicant’s adult brother Marvin Tibo. The two-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Applicant had the wrong size fire extinguisher. LPAs advised applicant to obtain a 2A:10 BC fire extinguisher. Applicant did not have a functioning carbon monoxide detector. Smoke detector was operational. Hazardous items were accessible in multiple areas of the home. Applicant stated he would latch cabinets/drawers in bathrooms and kitchen. See list of corrections on page 4. LPA Lane will go back to the facility for a secondpre-licensing inspection once all corrections have been completed. The neighbor has a pool that is fenced next door. The backyard is off-limits but needs additional screw locks on both sliding glass doors to make it inaccessible. LPA observed a fountain and body of water in the off-limits backyard. The fireplace is not screened and the staircase is not barricaded at the bottom or top. There is a working phone at the facility. Applicant states that there are no weapons in the home. Applicant states that they have sufficient financial resources to sustain the license. CPR and First Aid expire on November 2025. Preventative health practices course was completed on 2/29/24 which includes lead poison prevention training. Mandated reporter training was not complete, however applicant speaks and understands English. LPA advised applicant to complete the mandated reporter training at: www.mandatedreporterca.com and submit completed certificate to LPA via e-mail by March 25, 2024. Staff immunization requirements were met. Required documents have been posted. The applicant does not have toys or equipment ready and available. (continued on LIC809-C...)

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024

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: TIBO, MARIEWS FAMILY CHILD CARE	FACILITY NUMBER: 376101735
	VISIT DATE: 03/15/2024

NARRATIVE

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Applicant needs to provide an updated sketch of both the first and second floor including off-limit areas. Applicant will be using the following rooms for childcare: big living room, small living room, bathroom #1, kitchen and upstairs bedroom #1, upstairs bedroom #2 and bathroom #2 (also upstairs). Off-limits areas include: upstairs bedroom #3 and upstairs master bedroom and are not yet inaccessible as applicant needs to install latches on the door knobs. The garage will also be off limits and is currently accessible, as applicant will install a latch on the door and locks. Backyard is also off-limits but accessible at this time. Applicant needs to install screw locks on the sliding glass doors that have access to the backyard. Applicant stated that he will take the children to a nearby park for outdoor activities and understands that visual supervision is required at all times. LPA observed multiple hazards and a fountain with body of water in the backyard, which is why applicant decided to make backyard off-limits at this time.

Applicant also stated he wishes to include his mother Vivian Elias as a co-licensee. LPA stated once licensed he can update the license to include her as a co-licensee. LPA sent the required list of documents to applicant via e-mail.

The new provider packet was reviewed with the applicant including information on child abuse and unusual incident reporting. LPA provided information regarding 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.

The applicant provided proof of control of property. Applicant owns the home.

LPA reviewed with applicant 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. (continued on LIC809-C...)

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024

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: TIBO, MARIEWS FAMILY CHILD CARE	FACILITY NUMBER: 376101735
	VISIT DATE: 03/15/2024

NARRATIVE

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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.

On this date, 3/15/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

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) or (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. (continued on LIC809-C...)

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024

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: TIBO, MARIEWS FAMILY CHILD CARE	FACILITY NUMBER: 376101735
	VISIT DATE: 03/15/2024

NARRATIVE

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Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

The following corrections are needed prior to the issuance of the license:
1. Install screw lock on sliding glass doors in big living room and small living room to make backyard inaccessible
2. Applicant needs to obtain toys and equipment for the daycare
3. Install latches on sink cabinet & kitchen drawers & also in bathroom #2
4. Make fire place inaccessible with a screen
5. Install latch on garage door or lock that is not reachable by child/applicant is install a new door
6. Bedroom #1 & bedroom #2 (upstairs) need screw locks on the windows preventing them from opening more than 4 inches
7. Bedroom 3 and Master bedroom need to be made inaccessible by installing latches on the doors
8. Install safety gates at the bottom and top of the stairs
9. Obtain the correct size fire extinguisher 2A:10BC
10. Obtain functioning carbon monoxide detector
11. Complete facility sketch for lower and upper levels that is more accurate and lists off-limit areas
12. Complete mandated reporter training at: www.mandatedreporterca.com and submit certificate to LPA Lane via e-mail or at 2^nd prelicensing inspection.
(continued on LIC809-C...)

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024

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: TIBO, MARIEWS FAMILY CHILD CARE	FACILITY NUMBER: 376101735
	VISIT DATE: 03/15/2024

NARRATIVE

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Once all corrections are made, LPA will conduct a second pre-licensing inspection to check all corrections have been completed. Once all corrections have been approved by the LPA, a license for 8 children may be granted. Applicant understands that proof of corrections must be submitted to Licensing within 30 days or the 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 applicant Mariews Tibo.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024

LIC809 (FAS) - (06/04)

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