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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376625142
Report Date: 01/14/2022
Date Signed: 01/14/2022 10:46:37 AM

Document Has Been Signed on 01/14/2022 10:46 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:IRIARTE, GLADYS FAMILY CHILD CAREFACILITY NUMBER:
376625142
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
01/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Gladys IriarteTIME COMPLETED:
11:00 AM
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On 1/14/21 at 8:40 am Licensing Program Analyst (LPA) Annette Sutherland arrived at the facility to conduct an unannounced annual inspection. LPA was granted entry by licensee Gladys Iriarte. Also present was her husband Pablo Tolentino. Licensee was provided the Inspection Checklist (LIC 126) upon entry to the facility. The one -story home was toured and inspected to ensure an environment safe for the care and supervision of children. There are 5-day care children in the home, one of whom is 5 months.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for childcare include Living room, Dining room, Kitchen, Bedroom #1 and backyard. Off limits areas include Bedroom #2 and Bathroom #3. These areas are inaccessible through use of doorknob covers. There is a working phone at the facility. The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children. Inaccessibility of hazards must be constantly reassessed depending on the children in care. There are no stairs or fireplace in the home.

Verification of control of property is on file. Licensee rents the home. Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted. Pediatric CPR and First Aid Card expires on May 2022. Licensee meets immunization requirements. Mandated Reporter has expired. Licensee has conducted disaster drills; last drill was conducted on 11/30/21. Children’s records were reviewed. Licensee has a completed roster.

Continued on LIC 809 C
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2022
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: IRIARTE, GLADYS FAMILY CHILD CARE
FACILITY NUMBER: 376625142
VISIT DATE: 01/14/2022
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There are no bodies of water. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.

No guns or weapons present as stated by the Licensee. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations. The home is clean and orderly, with heating and ventilation for safety and comfort. Safe and age appropriate toys and equipment are present for both indoor and outdoor activities. Licensee stated that she bring the children to the outdoor grass area within the gated complex.

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.

The inspection consisted of reviews of the following domains: Physical Plant, Care and Supervision, Facility Administration, Records, Staffing Ratio and Capacity, and Personal Rights.

Access to forms & Regulations for Family Child Care are online at www.ccld.ca.gov. Please note it is you Responsibility to know the regulations for anyone providing care. The Duty Officer is available to answer questions Monday – Friday at (619) 767-2248 for any Unusual Incident Reporting.


Continues LIC 809C
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022
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: IRIARTE, GLADYS FAMILY CHILD CARE
FACILITY NUMBER: 376625142
VISIT DATE: 01/14/2022
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page 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.

Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; 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. LPAs and Licensee discussed California Megan's Law and LPAs provided: www.meganslaw.ca.gov.

LPA reviewed Covid-19 guidelines with Licensee and provided Covid-19 resources. Please subscribe to childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov.

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.htm

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.
Continued on 809c
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: IRIARTE, GLADYS FAMILY CHILD CARE
FACILITY NUMBER: 376625142
VISIT DATE: 01/14/2022
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No Deficiencies are cited. See Technical Advisory Attached.

Exit interview conducted and report was reviewed with the licensee, Glady Iriarte. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5