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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376616412
Report Date: 11/18/2024
Date Signed: 11/18/2024 02:46:12 PM

Document Has Been Signed on 11/18/2024 02:46 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:MEDINA, ANGELA FAMILY CHILD CAREFACILITY NUMBER:
376616412
ADMINISTRATOR/
DIRECTOR:		ANGELA MEDINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 698-6035
CITY:SAN DIEGOSTATE: CAZIP CODE:
92119
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 8DATE:
11/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Licensee, Angela MedinaTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 11/18/2024, Licensing Program Analysts (LPAs), Saraliz Velando and Hanna Lucas conducted an unannounced Annual Licensing Inspection. LPA was greeted by licensee, Angela Medina and her husband/helper, Hubert Medina. LPA was granted entry after identifying herself and disclosing the purpose of the visit. There were 8 children in care today.

Areas used for child care include play room, play room bathroom, living room, dining room, kitchen, and fenced backyard. Off limits areas include laundry room, hall bathroom near master bedroom, master bedroom, and extra bedroom and they are inaccessible through use of child safety latches and locks.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Home is clean, orderly and has adequate ventilation. Children’s toys and play equipment are available and observed free of hazards. There is a working telephone/email address. All cleaning compounds, detergents, medications, and poisons are made inaccessible through latches, placed up on high surfaces, and off limit areas. The fireplaces are screened for safety. The fire extinguisher meets regulations and is located in the kitchen area. Licensee states there are NO firearms in the home and LPA did not observe any. The outdoor play area is fenced and free of hazardous items. The licensee has a hot tub that is secured by a cover that has locks and can hold the weight of an adult. There are no new adults living or working in the home over the age of 18 years. All adult residents and helpers have been fingerprint cleared. Pediatric CPR and First-Aid certificate expires November 2026 for Licensee and has a current Mandated Reporter Training certificate that expires October 2026.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 11/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/18/2024
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: MEDINA, ANGELA FAMILY CHILD CARE
FACILITY NUMBER: 376616412
VISIT DATE: 11/18/2024
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share Licensee or facility representative was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain 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 licensee or facility representative 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 for facility representative 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 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.htmyour inspection experience. If you have any questions regarding the process or tools, please send them by email to: inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

No deficiencies were cited today.

Exit interview was conducted and report was reviewed with licensee, Angela Medina. Copy of report and Appeal Rights was given. A notice of site visit was posted and must remain for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2024
LIC809 (FAS) - (06/04)
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