376617664-12-11-2024-20-CC-SZAA-DBV29F-20241211161152

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376617664
Report Date: 12/11/2024
Date Signed: 12/11/2024 04:12:00 PM

Document Has Been Signed on 12/11/2024 04:12 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	CERVANTES, EDNA FAMILY CHILD CARE		FACILITY NUMBER:	376617664
ADMINISTRATOR/ DIRECTOR:	EDNA CERVANTES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 425-5196
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 12	DATE:	12/11/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:50 PM
MET WITH:	Edna Cervantes		TIME VISIT/ INSPECTION COMPLETED:	04:20 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 12/11/2024 at 1:54PM, Licensing Program Analyst (LPA) Saul Zazueta conducted an unannounced Annual inspection with Licensee, Edna Cervantes. LPA disclosed the purpose of the inspection and was led on a tour of the facility, both indoors and outdoors. This facility is a one-story, three (3) bedroom, two (2) bathroom house. The following areas are used for childcare: living room, dining room, daycare room, bedroom #1, bedroom #2, bathroom #1, and backyard. Off limits areas include bedroom #3, bathroom #2, kitchen, and garage. Off limits areas are inaccessible to children by use of safety gates, safety latches and doorknob covers. Days and hours of operation are Monday through Friday, 7:00AM – 6:00PM. There was twelve (12) children and one (1) assistant present during the inspection. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements and were observed to be operational. LPA informed licensee that poisons, detergents, cleaning compounds, medications and other hazardous items shall be placed in a storage area and locked. LPA observed that all hazardous items were made inaccessible to children by use of door knob covers and cabinet locks. Backyard is used for outdoor activities. LPA informed licensee to ensure that children are supervised at all times during outdoor activities. The fireplace located in the living room and is made inaccessible by the use of safety latches. Licensee stated that there are no pool or bodies of water on the premises, which was confirmed by LPA during inspection. Licensee has children's toys, play equipment and books available. Licensee has a working cell phone. Licensee stated that there are no firearms, other weapons, or ammunition in the home. 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. LPA reviewed children’s files. Four (4) out of twelve (12) children’s files were incomplete. Licensee stated that four (4) out of twelve (12) children present were her grand children, which had accompanied her daughter that was assisting for the day so they had no files or documents.

SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Saul Zazueta
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CERVANTES, EDNA FAMILY CHILD CARE	FACILITY NUMBER: 376617664
	VISIT DATE: 12/11/2024

NARRATIVE

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Licensee’s Mandated Reporter AB1207 training expires on 01/16/2026. Pediatric CPR and First Aid certification expires on 05/18/2025. Licensee has required immunizations, per file review. Required documents were posted during the time of inspection. Facility roster is maintained and was reviewed. The licensee conducted and documented a fire and disaster drill on 11/25/2024. There is one crib or play yard for each infant who is unable to climb out of the crib or play yard.

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.

LPA discussed 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. 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 the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care. LPA reviewed with licensee 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.

SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Saul Zazueta
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CERVANTES, EDNA FAMILY CHILD CARE	FACILITY NUMBER: 376617664
	VISIT DATE: 12/11/2024

NARRATIVE

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

On this date, 12/10/2024, 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. LPA discussed California Megan's Law with licensee and provided: www.meganslaw.ca.gov. Licensee, Edna Cervantes, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

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 your 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/process.

Per California Code of Regulations, (Title 22, division 12 & Chapter 3) one (1) Type B is being cited on the attached LIC 809-D. A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and this report was reviewed with Licensee, Edna Cervantes.

SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Saul Zazueta
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/11/2024 04:12 PM - It Cannot Be Edited

Created By: Saul Zazueta On 12/11/2024 at 03:20 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CERVANTES, EDNA FAMILY CHILD CARE	FACILITY NUMBER: 376617664
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(7)

Operation of A Family Child Care Home

(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above in four (4) out of twelve (12) children in care did not have any documents on file, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/16/2024
	Plan of Correction
1 2 3 4	Licensee stated that she will obtain all required documentation for the four children and submit copies to the San Diego Regional Office by 12/16/2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Jason Garay

LICENSING EVALUATOR NAME:

Saul Zazueta

LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

LIC809 (FAS) - (06/04)

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