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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629390
Report Date: 09/05/2023
Date Signed: 09/05/2023 11:55:01 AM

Document Has Been Signed on 09/05/2023 11:55 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:LEPE, LINA FAMILY CHILD CAREFACILITY NUMBER:
376629390
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
09/05/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Lina Lepe, ProviderTIME COMPLETED:
12:00 PM
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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 assistant Yessica Torres, who was advised of the purpose of today’s inspection. Licensee Lina Lepe arrived to the facility shortly after. 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: living room, dining room, room #2, hallway bathroom and back yard. Off limit areas include: bedroom #1, master bedroom (converted garage) and laundry room. 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 drawers are secured and chemicals are not accessible to children.

A review of the children records child #1 & #2 did not have immunization records in file. Child #1 have been attending daycare since February 2023.

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: 09/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2023
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: LEPE, LINA FAMILY CHILD CARE
FACILITY NUMBER: 376629390
VISIT DATE: 09/05/2023
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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.

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.

A Regular Large Family Child Care Home license may be issued upon final file review.



California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 809-D.

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

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: 09/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/05/2023 11:55 AM - It Cannot Be Edited


Created By: Diana Sanchez On 09/05/2023 at 11:33 AM
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: LEPE, LINA FAMILY CHILD CARE
FACILITY NUMBER: 376629390

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/15/2023
Section Cited
CCR
102418(g)

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The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.
This requirement is not met as evidenced by:
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Licensee Lina Lepe told LPA that she will ensure to obtain the immunizations from the parents and place a copy in the children's records. Licensee will email a copy of the immunization record to the San Diego Child Care Regional Office (SDCCRO) as proof of corrections.
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Based on interview with licensee and records reviewed, the licensee did not comply with the section cited above, by not having Child 1 & 2 immunizations, which poses a potential Health and Safety risk to children in care.
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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:Diana Sanchez
LICENSING EVALUATOR SIGNATURE:
DATE: 09/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/05/2023


LIC809 (FAS) - (06/04)
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