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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629309
Report Date: 04/11/2022
Date Signed: 04/11/2022 12:30:09 PM

Document Has Been Signed on 04/11/2022 12:30 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:SALCEDO, JESSICA FAMILY CHILD CAREFACILITY NUMBER:
376629309
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/11/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Jessica SalcedoTIME COMPLETED:
12:35 PM
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On 04/11/2022 at 11:00 AM. Licensing Program Analyst (LPA) Dana Stevens conducted an announced pre-licensing inspection with applicant, Jessica Salcedo. Purpose of the inspection is Change of Location. This single- story, three bedroom, one bath home was toured and inspected to ensure compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. 

Applicant will use the following areas for child care: daycare room, kitchen, and bathroom. Off limits areas include: Living room, dining area, and garage. These areas are made inaccessible to day care children through the use of doorknob covers and a safety gate. Applicant will utilize the backyard for outdoor activities, it is properly fenced, and applicant stated total supervision will be provided during outdoor play. There are no bodies of water observed during time of visit. The fire extinguisher is rated 3A 40B:C and is located in the garage. Smoke and carbon monoxide detectors meet requirements and are operational. All poisons, detergents, cleaning compounds, and medicines are inaccessible to children in care and are located in off limit areas and secured out of reach of children.  Children’s toys and play equipment are available. The applicant has a working telephone/cell phone.  Applicant indicated there are no firearms or other weapons in the home. Pediatric CPR and First Aid certification expires 05/2022. Required documents are posted. 

Applicant 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 in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record 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. Any minor upon their 18th birthday must be fingerprinted within 30 days.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2022
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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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: SALCEDO, JESSICA FAMILY CHILD CARE
FACILITY NUMBER: 376629309
VISIT DATE: 04/11/2022
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LPA discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

Immunization records per SB792 were reviewed and are in compliance.  LPA advised that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. Applicant states they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes. The hours of operation are 7:00 -5:00 PM., Monday - Friday.



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
 
LPA reviewed with Applicant the Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.  Applicant was also informed the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers 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, 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.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022
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: SALCEDO, JESSICA FAMILY CHILD CARE
FACILITY NUMBER: 376629309
VISIT DATE: 04/11/2022
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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 license-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

A Regular Small Family Child Care Home license maybe issued upon final file review.  An exit interview was conducted and report was reviewed with applicant, Jessica Salcedo.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022
LIC809 (FAS) - (06/04)
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