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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626077
Report Date: 02/06/2023
Date Signed: 02/06/2023 02:10:27 PM

Document Has Been Signed on 02/06/2023 02:10 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:LEYVA, ADRIANA FAMILY CHILD CAREFACILITY NUMBER:
376626077
ADMINISTRATOR:ADRIANA LEYVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 755-3152
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
02/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Adriana Leyva TIME COMPLETED:
02:15 PM
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On 02/06/2023, at 12:20 p.m., Licensing Program Analyst (LPA), Rajani Goudreau conducted an unannounced Annual Inspection and met with the Licensee, Adriana Leyva. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. There was one child in care at time of inspection. In addition, licensees’ adult son was present in the home. The indoor and outdoor areas were toured and inspected. The following areas are used for childcare: living room, restroom in hallway and backyard. The following off-limit areas are made securely inaccessible: Second story of home; including bedrooms #1, #2, restroom, master bedroom and master bathroom, garage, TV room, dining room and kitchen. Facility operates Monday through Friday from 6:45 a.m. to 5:30 p.m.

The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements, per LPA observation. LPA observed hazardous items inaccessible to children in care. LPA informed licensee’s poisons shall be placed in a storage area and locked. There is a fireplace located in the TV room that is securely screened. No bodies of water were observed on the premises of property. Licensee confirmed there is no bodies of water on the premises of the property. Licensee stated there are no firearms or weapons in the home. LPA informed licensee the children shall be supervised during outdoor activities. 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. 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. Licensee First Aid and CPR certifications are valid and expire in June 2023. Licensee has required immunization’s on file, per file review. Mandated reporter training completed in November 2021. Last fire and disaster drills conducted in February 2023. LPA informed licensee the disaster drills shall be completed once every six months and documented. LPA observed required documents posted. A sample of children’s files were reviewed and complete. LPA observed one play yard for each infant. The play yards were observed to be free from all loose articles and objects.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Rajani Goudreau
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2023
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: LEYVA, ADRIANA FAMILY CHILD CARE
FACILITY NUMBER: 376626077
VISIT DATE: 02/06/2023
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Every infant 24 months and younger shall be checked on every 15 months and documentation shall be maintained in the infants file and shall include the following: Date, Time, and Infants name.  In addition, the Individual Infant Sleeping Plan [LIC 9227 (3/20)] was discussed. 

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.

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.

LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . LPA informed licensee in order to sign up for Quarterly Updates and PINs through our website. Please go to www.cdss.ca.gov and on the right side of your screen click on “Receive Important Updates”, put your email address in and choose which program(s) you would like to subscribe to and click “subscribe. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

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/inspection-process.

No deficiencies issued during today's inspection. Exit interview conducted and report reviewed with the Licensee, Adriana Leyva. A Notice of Site Visit (LIC9213) was given and must remain posted for 30 days from today’s date. LPA observed Notice of Site Visit posted prior to exiting facility.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Rajani Goudreau
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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