376626118-9-6-2022-51-CC-ASUD-CHZNXN-20220906105124

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376626118
Report Date: 09/06/2022
Date Signed: 09/06/2022 10:51:55 AM

Document Has Been Signed on 09/06/2022 10:51 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:	GONZALEZ, ELIZABETH & ESTRADA, NANCY FCC		FACILITY NUMBER:	376626118
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	09/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:24 AM
MET WITH:	Elizabeth Gonzalez & Nancy Estrada		TIME COMPLETED:	11:00 AM

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 9/6/22 at 9:32 AM Licensing Program Analyst (LPA) Annette Sutherland conducted an unannounced annual inspection with the Licensee. Upon arrival, LPA met with both Licensees Elizabeth Gonzalez and Nancy Estrada. Licensee was provided the Inspection Checklist (LIC 126). The 1 story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present in the home was 1-day care infant. 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, Bathroom #1 and Backyard. Off limits areas include Bedroom 1-4, Bathroom #2, and Garage and are inaccessible through use of doorknob covers. The licensee has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. LPA conducted childcare quality management interview with the Licensee. The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water on the property. Licensee states that there are no weapons in the home. First Aid and CPR certifications expire on February 2024 for Elizabeth, Nancy, and Jorge (Elizabeth's husband). Licensee has required immunizations. Licensee and daughter has not completed Mandated Reporter Training. But is advised that it must be completed every 2 years. Children’s records were reviewed and found to be in order. Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. Continued on LIC 809C

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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: GONZALEZ, ELIZABETH & ESTRADA, NANCY FCC	FACILITY NUMBER: 376626118
	VISIT DATE: 09/06/2022

NARRATIVE

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All equipment that is used should be used only as intended by the manufacturer. LPA reviewed Covid-19 guidelines with Licensee and provided Covid-19 resources. LPA directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
LPA discussed the safe sleep regulations with licensee and discussed the Childcare 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. 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 Childcare 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 and provided Licensee with the following: childcare advocates-email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Childcare Licensing Duty Line at (619) 767-2248.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Childcare Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Continued on LIC 809C

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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: GONZALEZ, ELIZABETH & ESTRADA, NANCY FCC	FACILITY NUMBER: 376626118
	VISIT DATE: 09/06/2022

NARRATIVE

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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 Childcare Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Deficiencies cited and Technical assistance attached.

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.

Exit interview conducted and report was reviewed with the licensees Elizabeth Gonzalez and Nancy Estrada. 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: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/06/2022 10:51 AM - It Cannot Be Edited

Created By: Annette Sutherland On 09/06/2022 at 10:06 AM

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: GONZALEZ, ELIZABETH & ESTRADA, NANCY FCC	FACILITY NUMBER: 376626118
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/06/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)(D)

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview with the Licesees this requirement was not met as licensees did not have infant sleep log available for review, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/09/2022
	Plan of Correction
1 2 3 4	Licensee will continue to check and now document infant sleeping progress on sleep logs(Date, Infant name, time of each 15 minute check) for infants currently in care and states will keep sleep logs as required for all children under 24 months.Licesee with email LPA a copy of safe sleep log by 9/9/22 to Annette.Sutherland@dss.ca.gov

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:

Monica Cuddy

LICENSING EVALUATOR NAME:

Annette Sutherland

LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

LIC809 (FAS) - (06/04)

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