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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629375
Report Date: 08/09/2022
Date Signed: 08/09/2022 10:19:19 AM

Document Has Been Signed on 08/09/2022 10:19 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:HERNANDEZ, GLORIA ZAMAYOA FAMILY CHILD CAREFACILITY NUMBER:
376629375
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
08/09/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Gloria Hernandez ZamayoaTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) D. Sanchez made an unannounced Case Management inspection in response to the increase of capacity request. LPA was greeted and allowed entry into the facility by Gloria Hernandez who was advised of the purpose of today’s inspection. Inspection was conducted in Spanish language. This facility is a single story, three bedroom, two bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection.

Daycare areas includes: Family room (main daycare room), living room, dining room, bedroom located next to the living room, hallway bathroom, side yard and backyard. Off limits areas includes: Master bedroom, bedroom located in the back, kitchen and garage. LPA noticed that all required notices, License and forms were properly posted. The house smoke and carbon monoxide detectors are operable and fire extinguisher is fully charged. The day care bathroom was inspected; the toilet and faucets are operational. The kitchen has been properly secured with a baby gate and chemicals are not accessible to children.

A review of all adults living in this home who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR are up to date. Provider stated that they do not have hand gun or ammunition in this house.

Per new Senate Bill 792 pertaining to immunizations, which require all adults in daycare operation to have proof of immunizations for; Measles, Pertussis or Whooping Cough and Influenza or Flu, LPA has verified that licensee has verification of required immunizations and is in compliance.

Assembly Bill 1207 Mandated Child Abuse Reporting. Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Diana Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2022
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: HERNANDEZ, GLORIA ZAMAYOA FAMILY CHILD CARE
FACILITY NUMBER: 376629375
VISIT DATE: 08/09/2022
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The maximum number of children for whom care shall be provided when there is an assistant provider in the home, including children under age 10 who live in the licensee's home and the assistant provider's children under age 10, shall be either: Twelve (12) children with no more than four of whom may be infants or Fourteen (14) children, at least two of the children are at least six years of age and no more than three infants with landlord consent.
Facility is currently in substantial compliance; all requirements for a large license have been met. A large license for a maximum capacity of 14 children will be granted effective today 8/09/2022.

LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
Community Care Licensing WEB SITE: http://www.ccld.ca.gov

LPA provided licensee with a copy of the SIDS Safe Sleep printout information, Safe Sleep Regulation Concepts and Lead Exposure brochure. LPA advised provider of the importance of child abuse reporting, children’s records, immunization, shaken baby syndrome and the YMCA Resource Center. LPA explained clearance requirements for persons over 18 residing or working in the facility. Provider understood that physical discipline/corporal punishment and smoking shall never be permitted in the child care program. Provider was also advised that exersaucers, bouncy, rockers, walkers shall never be permitted in the child care program.
No deficiencies were cited during today's inspection. An exit interview was conducted with Gloria Hernandez and a copy of this report left at the facility.

LPA observed provider placing the Notice of Cite Visit on the wall visible to parents during today’s inspection.

NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Diana Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC809 (FAS) - (06/04)
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