376629623-5-23-2023-20-CC-DSTS-CS4ULJ-20230523154050

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629623
Report Date: 05/23/2023
Date Signed: 05/23/2023 03:41:04 PM

Document Has Been Signed on 05/23/2023 03:41 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:	PENAGOS TORRES, LEIDY FAMILY CHILD CARE		FACILITY NUMBER:	376629623
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/23/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Leidy Penagos Torres		TIME COMPLETED:	03:50 PM

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 05/23/2023 at 02:00 PM, Licensing Program Analyst (LPA) Dana Stevens conducted an announced Pre-licensing/Change of Location inspection with applicant, Leidy Penagos-Torres. Purpose of the inspection to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This three bedroom, one bath home was toured and inspected. Applicant will use the following areas for child care: living room, dining area, hall bathroom . kitchen, and one bedroom. Off-limit areas are, two bedrooms. These areas have been made inaccessible with door knob covers. Applicant will utilize the back yard for outdoor activities. Applicant understands total supervision is required during outdoor play. There is no fireplace on the premises. There are no bodies of water observed during time of visit. Fire extinguisher, 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. Applicant maintains documentation of proof of control of property for review by the Department. Applicant completed Mandated Reporter AB1207 training in 03/2023. Pediatric CPR and First Aid certifications expire 03/2025. Required documents were posted. Applicant has criminal record clearances and/or exemptions on file. Applicant 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 are in compliance.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

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: PENAGOS TORRES, LEIDY FAMILY CHILD CARE	FACILITY NUMBER: 376629623
	VISIT DATE: 05/23/2023

NARRATIVE

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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 Monday - Friday 7:00 AM - 4:00 PM.

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

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.

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, or transfer their existing 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.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

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: PENAGOS TORRES, LEIDY FAMILY CHILD CARE	FACILITY NUMBER: 376629623
	VISIT DATE: 05/23/2023

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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 platforms.
To receive important licensed-related information to licensed facilities, visit the CCLD:https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Duty Line was provided: (619) 767-2248. Southern California Child Care Advocate information was provided and applicant was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

A Regular Family Child Care License may be issued upon final file review
.
An exit interview was conducted and a copy of the report was provided to the applicant.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:	DATE: 05/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2023

LIC809 (FAS) - (06/04)

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