376626229-8-23-2023-51-CC-GPOR-CUYV3J-20230823160448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376626229
Report Date: 08/23/2023
Date Signed: 08/23/2023 04:04:54 PM

Document Has Been Signed on 08/23/2023 04:04 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 NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	RIVERA, KARINA FAMILY CHILD CARE		FACILITY NUMBER:	376626229
ADMINISTRATOR:	KARINA RIVERA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(858) 208-6141
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92111
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 9	DATE:	08/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Karina Rivera		TIME COMPLETED:	04:15 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 8/23/23 at 1:05 pm Licensing Program Analyst (LPA) Gerald Poindexter conducted an unannounced annual inspection. Upon arrival, LPA met with licensee helpers Jannette Navarro and Yaribel Valdez. Licensee Katrina Rivera arrived at the home at approximately 1:40 pm. Also, in the home was licensee’s significant other, Oscar Nunez. Present in the home were nine day care children, three of whom were under 24 months. Licensee states they typically arrive from 7:30 am.

Licensee was provided the Inspection Checklist (LIC 126). The four-bedroom, two-bath, one-story home was toured and inspected to ensure an environment safe for the care and supervision of children.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas Licensee stated she uses for childcare include the following areas: family room, dining room kitchen, master bedroom, bedroom 3, bathroom, and backyard. Off limit areas include: two back bedrooms, master bathroom, and garage are inaccessible through use of door locks and doorknob covers. There are no stairs in the home. The facility has sufficient toys and equipment available.

The home has a fenced backyard available for outdoor activities. Licensee understands that direct visual observation must be always maintained during outdoor play. No body of water was observed during time of inspection.

There is a fully charged fire extinguisher, smoke and carbon monoxide detector that meet requirements and are operational. There is a screened fireplace that is also barricaded. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children via latches or high placement. Adequate heating and ventilation are provided. There is a working telephone/email address. Licensee stated there are NO firearms and weapons in the home.

CONTINUED ON PAGE 2

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: RIVERA, KARINA FAMILY CHILD CARE	FACILITY NUMBER: 376626229
	VISIT DATE: 08/23/2023

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
26
27
28
29
30
31
32

LPA observed all required postings were posted. Staff records were reviewed. Children’s records were reviewed and found to be in order. Licensee has the required immunizations per SB792. Licensee’s and both helpers’ Pediatric CPR/First Aid all expire 3/2024. Licensee’s Mandated Reporter Training Certificate is EXPIRED as of 6/13/23 and helpers Mandated Reporter Training Certificate per AB1207 are current (expiration 9/2/24, Ms. Valdez and expiration 8/10/24, Ms. Navarro) and must be renewed ever 2 years.

Emergency drills are conducted and documented with the last one being on 3/19/23. Licensee maintains a current roster of the children which LPA obtained during time of inspection. LPA verified that all adults living or working in the home have been fingerprint cleared and associated. Licensee maintains and updates all required records for children in care. LPA reminded Licensee that all unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619) 767-2203. Duty officer number is (619) 767-2248.

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 conducted child care quality management staff interview with the Licensee. 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-andresources/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.

CONTINUED ON PAGE 3

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: RIVERA, KARINA FAMILY CHILD CARE	FACILITY NUMBER: 376626229
	VISIT DATE: 08/23/2023

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
26
27
28
29
30
31
32

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 of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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 cited.

Exit interview conducted and report was reviewed with the licensee, Karina Rivera. During the exit interview, the LICENSEE Karina Rivera, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3