376630252-1-6-2025-20-CC-SWIS-DCNUCD-20250106142747

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376630252
Report Date: 01/06/2025
Date Signed: 01/06/2025 02:28:02 PM

Document Has Been Signed on 01/06/2025 02:28 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	RIVERA, TERESA FAMILY CHILD CARE		FACILITY NUMBER:	376630252
ADMINISTRATOR/ DIRECTOR:	TERESA RIVERA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 864-3312
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91913
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	01/06/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:30 PM
MET WITH:	Licensee, Teresa Rivera		TIME VISIT/ INSPECTION COMPLETED:	02:30 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 1/6/2025 at 12:30 PM, Licensing Program Analyst (LPA) Shannan Williams conducted an announced pre-licensing inspection for a change of location with the License, Teresa Rivera. The purpose of the inspection is to ensure that the home complies with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This 2-story 5-bedroom, 3 ½ -bath home was toured and inspected to ensure the environment is safe for the care and supervision of children. Per the Licensee, operation hours will be 24/7. The Licensee was informed and understands that no more than 23 hours of care can be provided per child per day. Care and supervision will be provided to children ages 5 years old to 13 years old. All areas on the Facility Sketch LIC999 were inspected. The facility is a two story single family home. The home includes: Living Room, Family Room, Dining Room, Kitchen, Bedroom #1, Bedroom #2, Bedroom #3, Bedroom #4, Bedroom #5, Bathroom #1, Bathroom #2, Bathroom #3 and Bathroom #4 (1/2) bath, Backyard (Fenced), and a garage. Based on the Facility Sketch LIC999 submitted, areas off-limits to children and parents are as follows: Applicant has designated the entire second floor, first floor Bedroom #1, and Garage as off-limits areas. There are child-proof locks on each of the doors, or gates to make it inaccessible to children in care. Areas Designated for Day Care Activities: The applicant has designated Living Room, Family Room, Kitchen, Dining Room, First Floor Bathroom and backyard (fenced) for daycare activities. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone or cell phone service, ventilation, and heating. The children’s bathroom was observed to be safe and there are no cabinets or drawers in the bathroom.

SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025

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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: RIVERA, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 376630252
	VISIT DATE: 01/06/2025

NARRATIVE

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LPA Williams observed detergents, cleaning compounds, medicines, sharp objects, and hazardous items that can pose a danger to children are made inaccessible to children through latches, locks, and /or placed up on high surfaces. The applicant was advised that any poisons must be locked with a key or combination lock. The applicant stated that there are no weapons or firearms in the house.

The pressure gauge on the 2A-10BC fire extinguisher indicates fully charged, as indicated on the service tag observed. Smoke and carbon monoxide detectors meet requirements and are operable. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

OUTDOOR PLAY AREA: Outdoor play activities will be conducted in back yard. There are safe toys, play equipment, and materials for children. Licensee also utilizes a neighborhood park. The Licensee was informed that direct supervision at all times is required for outdoor activities at the neighborhood park. There are no bodies of water on the premises.

The applicant stated she will provide food for the children. The applicant was informed that if children bring food from home, the children’s names must be labeled on their lunch bags and refrigerated/stored properly.

Per the applicant, children will nap in the living room. Children will nap on cots/mats and infants in cribs/play yards. The licensee understands that there shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

A records review indicates the applicant completed the required Health and Safety Training with Nutrition and Lead Poisoning components. The applicant has a current Pediatric First Aid and CPR certification that expires on 12/20/2026. A first aid kit is available at the facility.

SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025

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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: RIVERA, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 376630252
	VISIT DATE: 01/06/2025

NARRATIVE

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In the absence of the licensee, a qualified adult must be present to supervise the children—a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR certification, Pertussis, Measles, TB clearance, and Influenza and valid criminal record clearance that is associated with the licensed facility.

Annual fees must be paid by the due date, or a late fee shall be assessed and/or the License may be terminated.

Reporting Requirements:

1. Changes should be reported to the Department as soon as they occur, such as construction, remodeling, telephone number changes, and/or moving out from your home.

2. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

Each family childcare home must conduct fire drills and disaster drills at least once every six months. The licensee must document the date and time of each drill. This documentation must be kept at the facility for review by the Department.

No smoking, No Johnny jumpers, No saucer chairs: any other items that fall into that category are prohibited in the facility.

Inspection Authority: All adults living and working in the home shall be made aware of the Department’s right to inspection authority, which includes but is not limited to the right to enter the house when children are being cared for, interview children and adults, and review documentation.

Licensees must post each facility license number in all advertisements, publications, or announcements with the intent to attract clients.

SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025

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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: RIVERA, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 376630252
	VISIT DATE: 01/06/2025

NARRATIVE

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H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The applicant has submitted proof of immunizations.

Health and Safety Code 1596.7995: Beginning January 1, 2018, all licensed providers, applicants, directors, and employees must complete training as specified on mandated reporter duties. Training is available at www.mandatedreporterca.com. The applicant has completed the required mandated reporter training. Recertification is required every two years.

Criminal Record Clearance
The 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

The applicant rents the home and provided proof of control of property.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (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 the applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant

SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025

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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: RIVERA, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 376630252
	VISIT DATE: 01/06/2025

NARRATIVE

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On this date, 01/06/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

The applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with the applicant, Georgina Pinos. Appeal Rights were provided.

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 Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

On 01/02/2025 a fire clearance was approved for 14 children.

The maximum capacity for a large family child care home: 12 children (with a qualified assistant) with no more than 4 infants; or (with landlord consent) 14 children (with a qualified assistant) with no more than 3 infants, 1 child enrolled in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. When there are no Qualified Assistants, 14 years of age or present, the capacity reverts to the requirements for a Small Family Child Care. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.
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SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025

LIC809 (FAS) - (06/04)

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