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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627767
Report Date: 08/15/2022
Date Signed: 08/15/2022 10:18:33 PM

Document Has Been Signed on 08/15/2022 10:18 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:QUINONEZ, DORALY FAMILY CHILD CAREFACILITY NUMBER:
376627767
ADMINISTRATOR:DORALY QUINONEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 666-8684
CITY:SAN DIEGOSTATE: CAZIP CODE:
92116
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
08/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:22 PM
MET WITH:Maria GonzalezTIME COMPLETED:
05:42 PM
NARRATIVE
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On 8/15/22 at 2:22PM, Licensing Program Analyst (LPA), Martha Malane conducted an unannounced annual inspection and met with licensee’s helpers, Maria Gonzalez and Viridiana Bernal. LPA disclosed the purpose of the inspection and was led on a tour of the facility. Translation provided by Language Link translators ID# 13103 and 15076. There were 11 children in care, four of whom were infants. This facility is a two bedroom, one bathroom home with an unattached room and bathroom. The following areas are used for childcare: kitchen, living room, dining room, bedroom 2 and bathroom. Off-limit areas include: bedroom 1 and unattached room and bathroom which are made inaccessible. Hours of operation are Monday - Friday 7:30am - 5:30pm.

The fire extinguisher, smoke detector and carbon monoxide detector met requirements. LPA observed hazardous items inaccessible to children in care. LPA informed helpers, poisons shall be placed in a storage area and locked. LPA observed toys and materials available for the children. The home has a fenced backyard available for outdoor activities. LPA informed licensee’s helpers, children shall be supervised during outdoor activities. Licensee's helpers stated there are no bodies of water and LPA did not observe any bodies of water. Licensee’s helper stated there are no weapons in the home.

Licensee’s helper 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. One of licensee’s helpers, Adult 1 (A1) has been working at the facility since July 2022 and does not have a criminal background clearance, see LIC809D deficiency cited and civil penalty assessed.

Maria Gonzalez’s first aid and CPR certifications expire 8/22/23 and mandated reporter certificate expired 8/30/22. The last fire/disaster drills were conducted and documented 10/2021, Technical Assistance provided. See LIC809C continuation...
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2022
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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Document Has Been Signed on 08/15/2022 10:18 PM - It Cannot Be Edited


Created By: Martha Malane On 08/15/2022 at 04:49 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: QUINONEZ, DORALY FAMILY CHILD CARE
FACILITY NUMBER: 376627767

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(d)(1)
Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in one (1) out of two (2) helpers did not have a criminal background clearance which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/16/2022
Plan of Correction
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A1 stated she will submit the required LIC508 form to CCL by 8/16/22 and not return to the facility until a criminal background clearance is granted.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Tulam Vu
LICENSING EVALUATOR NAME:Martha Malane
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/15/2022 10:18 PM - It Cannot Be Edited


Created By: Martha Malane On 08/15/2022 at 04:49 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: QUINONEZ, DORALY FAMILY CHILD CARE
FACILITY NUMBER: 376627767

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in three (3) out of six (6) child files did not have immunization records on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/31/2022
Plan of Correction
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Licensee will submit proof of immunization records for C2, C3 and C4 to CCL by 8/31/22.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Tulam Vu
LICENSING EVALUATOR NAME:Martha Malane
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2022


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: QUINONEZ, DORALY FAMILY CHILD CARE
FACILITY NUMBER: 376627767
VISIT DATE: 08/15/2022
NARRATIVE
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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: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with Maria Gonzalez 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.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations deficiencies were cited, see next page LIC809D.

Exit interview conducted with licensee's helper, Maria Gonzalez.

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.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022
LIC809 (FAS) - (06/04)
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