Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376618722
Report Date: 05/30/2018
Date Signed: 05/30/2018 02:54:53 PM

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:ARINDUQUE, KATHI FAMILY CHILD CAREFACILITY NUMBER:
376618722
ADMINISTRATOR:KATHI ARINDUQUEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 475-0262
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY:14CENSUS: 10DATE:
05/30/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Kathi Arinduque, ProviderTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Diana Sanchez conducted an Annual/Random inspection on today's date, at the above referenced facility. LPA was greeted and allowed entry into the facility by provider Kathi Arinduque, who stated that she currently has 12 school age children enrolled in the daycare. There were 10 school age children and an assistant present during today's inspection. Provider stated that she works full time at the Zamorano elementary school. She works Monday thru Friday from 7:30 a.m. thru 2:00 p.m. She then comes home and start caring for school age children after school from 2:00 p.m. to 6:00 p.m.
LPA stated purpose of today’s inspection is to ensure that the facility is in compliance with the rules and regulations of California Code of Regulations, Title 22, Division 12, Chapter 3, Regulations governing Family Child Care Homes. The facility is a single story three bedroom home. LPA toured the facility and noticed that all required notices and forms were properly posted. The house smoke, carbon monoxide detectors are operable and fire extinguisher is fully charged.

The daycare areas include: living room, hallway bathroom, dining room, kitchen and backyard. The off limit areas include: All bedrooms and garage.
The day care bathroom was inspected, LPA found shampoo bottles and shaving razor in bathtub shower. LPA also found mouthwash, deodorant and razors inside the unsecured medicine cabinet. All accessible to children.
The kitchen was inspected, all bottom drawers are secured and chemicals are not accessible to children.
Facility's backyard is fully fenced, there are plenty of toys and equipment for outside activities.

A review of all adults living in this home who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Provider's First Aid and CPR is up to date. Provider stated that they do not have hand gun or ammunition in this house.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana SanchezTELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2018
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: ARINDUQUE, KATHI FAMILY CHILD CARE
FACILITY NUMBER: 376618722
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/31/2018
Section Cited
CCR
102417(g)(4)
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102417(g)(4) Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger to children shall be stored where they are inaccessible to children.
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Provider Kathi Arinduque immediately removed all items during inspection. No further plan of correction needed. This deficiency was cleared during today's inspection.
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LPA found shampoo bottles and shaving razor in bathtub shower. LPA also found mouthwash, deodorant and razors inside the unsecured medicine cabinet. All accessible to children.
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Type B
06/08/2018
Section Cited
HSC
1597.622(a)(1)
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Effective 9/1/16, a person shall not be employed at a family day care home if he/she has not been immunized against influenza, pertussis, & measles. Provider & assistant were unable to provide proof of immunizations. This poses a potential health & safety risk to children in care.
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Provider Kathi stated that she will ensure to obtain hers and assistant required immunizations. She will send a copy to the San Diego Child Care Regional Office (SDCCRO) as proof of correction.
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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 GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana SanchezTELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2018
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: ARINDUQUE, KATHI FAMILY CHILD CARE
FACILITY NUMBER: 376618722
VISIT DATE: 05/30/2018
NARRATIVE
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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 were discussed with Licensee. Provider and assistant did not have immunization records available during inspection.

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.

Incidental Medical Services (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 gave provider a copy of the SIDS safe sleep printout information and advised her 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.

Community Care Licensing WEB SITE: http://www.ccld.ca.gov

An exit interview was conducted with Kathi Arinduque and a copy of this report and LIC-809D left at the facility as well as appeal rights. During the course of this evaluation, LPA advised Kathi that all request for extensions of any citations/Proof of Corrections (POCs) must be made within 10 days to the issuing LPA on or before the date the POC is due. Appeals to citations must be made within 15 days in writing to the issuing LPA's supervisor on or before the date the POC is due.
LPA observed provider placing the Notice to Cite Visit on the wall visible to parents during today’s inspection.
NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana SanchezTELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2018
LIC809 (FAS) - (06/04)
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