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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628539
Report Date: 05/14/2024
Date Signed: 05/14/2024 03:34:21 PM

Document Has Been Signed on 05/14/2024 03:34 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:GAMBOA, MARIA FAMILY CHILD CAREFACILITY NUMBER:
376628539
ADMINISTRATOR/
DIRECTOR:
MARIA GAMBOAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 452-8760
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
05/14/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee Maria GamboTIME VISIT/
INSPECTION COMPLETED:
03:40 PM
NARRATIVE
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On 05/14/2024, at 1:00pm, Licensing Program Analyst (LPA), Daniela Huerta conducted an unannounced Annual Inspection and met with Licensee, Maria Gambo. LPA disclosed the purpose of the inspection and was led on a tour of the facility indoors and outdoors. This facility is a two story, three-bedroom, three-bathroom townhouse. The following areas are used for childcare: living room, kitchen, bathroom #1 and backyard. Off limits areas include: bedroom #1-3, bathroom #2-3 located upstairs and garage which are made inaccessible through the use baby gates, locks and doorknob covers. The fireplace located in the living room is inaccessible to children. LPA informed licensee when children less than five years old are in care, stairs shall be fenced or barricaded. Stairs are inaccessible to children through a baby gate.

Hours of operation hours are Monday – Friday 8:00am to 5:00pm. There were seven (7) children present during the inspection and one (1) assistant.

The fire extinguisher, smoke detector and carbon monoxide detector met requirements. Hazardous items were inaccessible to children in care. LPA informed licensee poisons shall be placed in a storage area and locked. LPA did not observe any poisons during the inspection. LPA observed toys and materials available for children’s use. The home has a fenced backyard available for outdoor activities. LPA informed licensee to ensure children are supervised at all times during outdoor activities. Licensee stated there are no bodies of water and LPA did not observe any bodies of water during the inspection. Licensee stated there are no firearms, other weapons or ammunition in the home.

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.

LPA reviewed children’s files. Children’s files reviewed were complete and met regulations.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Daniela Huerta
LICENSING EVALUATOR SIGNATURE: DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2024
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 05/14/2024 03:34 PM - It Cannot Be Edited


Created By: Daniela Huerta On 05/14/2024 at 02:51 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: GAMBOA, MARIA FAMILY CHILD CARE

FACILITY NUMBER: 376628539

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 05/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and Licensee's statement that she was unable to provide a copy of the Mandated Reporter Training Certificate, the licensee did not comply with the section cited above in that she was unable to provide copy of the Mandated Reporter Training course, which poses as a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/28/2024
Plan of Correction
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LPA provided Licensee with written instructions on how to locate the Mandated Reporter Training online. Licensee states she will complete this online course and provide LPA with a copy of her training completion certificate no later than 05/20/2024.
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:Jason Garay
LICENSING EVALUATOR NAME:Daniela Huerta
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024


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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GAMBOA, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376628539
VISIT DATE: 05/14/2024
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Licensee and adult residents in the home have criminal record clearances and/or exemptions on file. Applicant 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.


Licensee was unable to provide proof of the Mandated Reporter AB1207 training certificate and licensee was unsure of when she took the course. See LIC809-D. Pediatric CPR and First Aid certifications expire on 01/2026. Property Owner/Landlord Consent form LIC9149 is on file, signed by landlord and approves licensee to care for fourteen (14) children. Licensee has required immunizations, per file review. Facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 01/20/2024. Required documents are posted.

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. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.


LPA discussed 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.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Daniela Huerta
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GAMBOA, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376628539
VISIT DATE: 05/14/2024
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

On this date, 05/14/2024, the California Attorney General - Megan’s Law website (meganslaw.ca.gov) was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.


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/tion-process.

Per California Code of Regulations, (Title 22, division 12 & Chapter 3) one (1) Type B citation is being cited on the attached LIC 809-D.

Exit interview conducted and report was reviewed with licensee, Maria Gamboa. A copy of this report, along with Appeal Rights (LIC9058), were provided. A notice of site visit was given and must remain posted for 30 days. LPA observed that the notice of site visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Daniela Huerta
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC809 (FAS) - (06/04)
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