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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629164
Report Date: 09/14/2021
Date Signed: 09/14/2021 12:41:22 PM

Document Has Been Signed on 09/14/2021 12:41 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:MALDONADO, LUIS FAMILY CHILD CAREFACILITY NUMBER:
376629164
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/14/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Luis MaldonadoTIME COMPLETED:
12:45 PM
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LPA, Luigi Gargaro, conducted an announced prelicensing inspection with the applicant. The purpose of the visit is to ensure the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Applicant does have firearms in the home but reviewed them with analyst today and analyst confirmed that weapons and ammunition were secured in separately locked areas.. A review of records on this date indicates that most adults or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Applicant rents the home and provided proof of control of property in the form of a lease agreement that he gave to analyst during today's visit. First Aid and CPR expire on July 2023.

Applicant will be using the following rooms for childcare: the living room, the dining area, the enclosed patio day care area and the day care bathroom. The following areas will be off limits: the kitchen, the three home bedrooms and the garage. The kitchen is made off limits with a child safety gate that is installed at its entryway, the bedrooms are made off limits with door knob covers that are installed on their respective door handles while the garage entry door, which is in the back of the off limits kitchen, is also further secured with an installed door knob cover and highly placed latch. The applicant has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. The yard has an off limits shed which is made that way with an installed padlock. The yard has a secondary section which is made off limits with fencing and a latching gate. This yard contains a jacuzzi which still needs to be secured.

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.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 09/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/14/2021
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: MALDONADO, LUIS FAMILY CHILD CARE
FACILITY NUMBER: 376629164
VISIT DATE: 09/14/2021
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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 Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA and applicant discussed California Megan's Law and he provided applicant with the website address: www.meganslaw.ca.gov for him to review information regarding his facility on a regular basis.

The new provider packet was reviewed with the applicant including information on child abuse reporting, children’s records, immunizations, adults living or working in the home, shaken baby syndrome, SIDS, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care.

A license for 8 will be issued after the following corrections have been completed: 1) applicant will install latches to secure the cover to his jacuzzi to make it inaccessible and will send in a photograph to show the correction is completed. Applicant has until 09/18/21 to complete the correction; 2) applicant's clearances are currently listed as pending though showing overall cleared in licensing system. Analyst will await final clearance update and advise applicant when received. Community Care Licensing web site: http://ccld.ca.gov
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021
LIC809 (FAS) - (06/04)
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