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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610546
Report Date: 08/25/2022
Date Signed: 08/25/2022 10:56:33 AM

Document Has Been Signed on 08/25/2022 10:56 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:COTA, EDA FAMILY CHILD CAREFACILITY NUMBER:
136610546
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 3DATE:
08/25/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Eda CotaTIME COMPLETED:
11:15 AM
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On 8/25/22 at 10:15 AM, Licensing Program Analyst (LPA) Crystal Tillory conducted an unannounced case management – licensee initiated, capacity increase inspection. Upon visit, LPA met with Licensee, Eda Cota, and proceeded to tour the home. During the visit there were 3 children in care. The following areas will be used for daycare purposes: living room, kitchen and dining area, daycare room, hallway bathroom. The fully fenced backyard will be used for outdoor play. Off limit areas include: front yard, garage, all bedrooms, and laundry room. Off limits areas are made inaccessible to daycare children through the use of door locks, safety latches, gates. Facility operating hours are from Monday through Sunday, 23 hours. All cleaning compounds, detergents, medications and other items which could pose a danger to children are stored where they are inaccessible to children and poisons are locked away. LPA observed the fire extinguisher, smoke and carbon monoxide detectors meet requirements and are operational. LPA observed required postings posted. Children’s toys and play equipment are safe and age appropriate. There are no bodies of water observed by LPA during inspection. There are no firearms or other weapons in the home, per licensee. Pediatric CPR and First-Aid certificate are valid through 03/2023. Licensee has more than one year of experience as a regulated small family childcare home operator.

Licensee 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.

Fire Clearance was granted on 8/11/2022.

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 See LIC809 continuation page…
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Crystal Tillory
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2022
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: COTA, EDA FAMILY CHILD CARE
FACILITY NUMBER: 136610546
VISIT DATE: 08/25/2022
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LPA discussed the safe sleep regulations with applicant, and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed with 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.

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 platform.
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.

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 infants (birth to 24 months) or Fourteen (14) children with 1 child in kindergarten and 1 child at least 6 years old, and no more than three infants. Licensee is aware she must notify the parents of the children in care when caring for more than 12 children. When there is no qualified assistant the capacity reverts back to the requirements from a small childcare.

No deficiencies issued during today’s visit. An exit interview was conducted and the report was reviewed with the licensee Eda Cota. 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. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

A Regular Large Family Child Care Home license will be issued for 14 children effective 08/25/22.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Crystal Tillory
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022
LIC809 (FAS) - (06/04)
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