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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610552
Report Date: 03/21/2022
Date Signed: 03/21/2022 12:09:36 PM

Document Has Been Signed on 03/21/2022 12:09 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:TERRIQUEZ ESPINOZA, YBETH FAMILY CHILD CAREFACILITY NUMBER:
136610552
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/21/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Ybeth RuizTIME COMPLETED:
12:15 PM
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On March 21, 2022 at 10:15 PM, Licensing Program Analyst (LPA) Gloria Gonzalez conducted an announced prelicensing inspection  with applicant, Ybeth Ruiz. LPA disclosed the purpose of the inspection and was granted a tour into the facility by the Applicant. Purpose of the inspection is 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 one story, 4 bedrooms, two bathroom home was toured and inspected. The hours of operation are Monday through Friday, 4:00 a.m. to 5:00 p.m.

Applicant will use the following areas for child care: living room, bathroom #1, bedroom #1, kitchen, dining room, and backyard. Off limits areas include: bedroom #2, #3, #4, bathroom #2, garage, and laundry room. Applicant states she will utilize the fenced backyard for outdoor activities.  Applicant stated there is no fireplace on the premises. Applicant stated there are no bodies of water and LPA did not observe any bodies of water during the time of inspection. The fire extinguisher is rated 2A 10B:C and is located in the kitchen., Smoke and carbon monoxide detectors meet requirements and are operational. Applicant was advised all poisons shall be locked. Applicant states detergents, cleaning compounds, and medicines are inaccessible to children in care and are located in off limit areas with cupboard latches and/or door locks and secured out of reach of children.  Children’s toys and play equipment are available. The applicant has a working telephone/cell phone.  Applicant states 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 has completed the Mandated Reporter AB1207 training certification on 1/17/22. Applicant has completed the 8 hours of preventative health. Pediatric CPR and First Aid certifications expire on 3/2023. Required documents are posted. 
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2022
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: TERRIQUEZ ESPINOZA, YBETH FAMILY CHILD CARE
FACILITY NUMBER: 136610552
VISIT DATE: 03/21/2022
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Applicant and adult residents in the home have criminal record clearances and exemptions on file.  Applicant was reminded 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 ta 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. 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.

Applicant does not plan on providing Incidental Medical Services (IMS) to clients at this time. 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)/ (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
 
The New Provider Resource Packet was reviewed with the applicant including information on the following:  Lead Exposure, SIDS, shaken baby, child abuse reporting, community resources, children’s records, facility records, required postings, immunizations, unusual incident report, facility roster, car seat law, visual for ratio/capacity, fire/disaster drill log and discussed California Megan's Law and LPA provided the following: www.meganslaw.ca.gov.  Applicant was also informed the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). LPA discussed the safe sleep regulations with applicant and discussed the Children Care Licencing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licencing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importante of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https/www.cpsc.gov/ and recommend they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.  LPA conducted technical support to provide applicant information regarding the COVID-19 disease. Corporal punishment and smoking are not allowed in the day care. 

Please visit the Guardian web page and set-up your Guardian account. https://cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian. If you have any questions regarding Guardian, please contact CDSS at email: guardian@dss.ca.gov
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022
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: TERRIQUEZ ESPINOZA, YBETH FAMILY CHILD CARE
FACILITY NUMBER: 136610552
VISIT DATE: 03/21/2022
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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, with landlord consent, 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. It should be noted that Landlord Consent, (LIC 9149), is not on file.

Community Care Licensing Division (CCLD) regularly sends information to licensed facility, 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 facility, visit the CCLD important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subsribe and select the Child Care option to receive email communication.

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

Exit interview conducted and report was reviewed and interpreted with the applicant, Ybeth Ruiz.  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 Entrance checklist was provided the applicants.

A Small Family Child Care Home license may be issued upon final file review. A copy of the report and appeal rights (LIC 9058) was provided to the applicant.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022
LIC809 (FAS) - (06/04)
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