376629225-12-2-2021-20-CC-JARL-C9BPPK-20211202102937

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629225
Report Date: 12/02/2021
Date Signed: 12/02/2021 10:31:13 AM

Document Has Been Signed on 12/02/2021 10:31 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:	PULIDO, VERONICA FAMILY CHILD CARE		FACILITY NUMBER:	376629225
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	12/02/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Veronica Pulido		TIME COMPLETED:	09:45 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 December 2, 2021 at 8:20 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a pre-licensing relocation inspection with Licensee Veronica Pulido. The inspection’s purpose is to ensure that the home follows standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. Language Link Operator 13884 provided translation services in Spanish. Present in the home was the Licensee and no children. This three (3) story, three (3) bedroom, three (3) bathroom single family house was toured and inspected. The daycare operational schedule will be weekdays 8 AM to 5 PM. Licensee will use the following areas for childcare: the family room and one (1) downstairs bathroom. These rooms are located on the bottom floor; stairs to this area are barricaded with a safety gate. The garage is located on the bottom floor and made inaccessible to children with the use of a door safety knob covering. The additional off limits areas include the living room, kitchen and rooms located on the second and top floors. The kitchen and stairs to the second floor are made inaccessible to day care children by use of safety gates. There are no bodies of water observed during time of visit. The fire extinguisher is rated 2A 10B: C. and located in the downstairs closet. The smoke and carbon monoxide detectors meets requirements and is operational. Medicines, poisons, detergents, and cleaning compounds are secured inaccessible to children in care by placement in an off limit area, whose access is barred with a safety gate. Children’s toys and play equipment are available. The Licensee has a working telephone/cell phone. The Licensee agreed to notify licensing should her telephone number or email address ever change. The Licensee indicated there are no firearms or other weapons in the home. Outdoor activities will be conducted in the fenced and shaded backyard. The Applicant acknowledges continuous, visual supervision shall be given whenever children are engaged in outdoor activities. The Licensee does not intend to transport the children in their own vehicle.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021

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: PULIDO, VERONICA FAMILY CHILD CARE	FACILITY NUMBER: 376629225
	VISIT DATE: 12/02/2021

NARRATIVE

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Licensee maintains documentation of proof of control of property for review by the Department. Licensee has completed the preventative health and lead poisoning prevention courses. The Mandated Reporter training was completed on 06/29/2021. Pediatric CPR and First Aid certifications expire in June 2023. The Licensee and adult residents in the home have criminal record clearances and/or exemptions on file. The Licensee was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon their 18th birthday must be fingerprinted within 30 days. Immunization records per SB792 were reviewed and comply. LPA advised that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. The Licensee states they are financially secure to operate a family childcare home for children and will comply with all regulations and laws governing family childcare homes.

The Licensee does not plan on providing Incidental Medical Services (IMS) to clients currently. 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

The Licensee was also informed the following items are prohibited during day care operating hours: walkers, exersaucers, jumpers, inclined sleepers and bouncy seats). Corporal punishment and smoking are not allowed in the day care.

LPA discussed the maximum capacity for a small family child care home: four infants only (infants mean any children under 24 months); or six children with no more than three infants; or, with landlord consent, eight children with no more than two infants, one child in kindergarten or elementary school and one child at least age six, including children under age 10 who live in the home. Landlord consent is on file.

The Licensee agrees to comply with all regulations and laws governing family childcare homes. The Licensee is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. The Licensing Duty Line was provided: (619) 767-2248. The

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021

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: PULIDO, VERONICA FAMILY CHILD CARE	FACILITY NUMBER: 376629225
	VISIT DATE: 12/02/2021

NARRATIVE

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Southern California Child Care Advocate (SCCCA) information was provided. LPA enrolled Licensee onto the SCCA email list through the CCLD website so she may receive updated regulation information. Advocate information was provided: (916) 654-1541 or childcareadvocatesprogram@dss.ca.gov.

No corrections are needed. A small license is issued effective today 12/02/2021. The new license will be mailed to the Licensee.

An exit interview was conducted with the Licensee. Licensee Rights (LIC 9098 01/16) along with a copy of this report was provided to the Licensee and their signature on this form confirms receipt of these rights.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021

LIC809 (FAS) - (06/04)

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