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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100691
Report Date: 04/30/2021
Date Signed: 04/30/2021 10:42:23 AM

Document Has Been Signed on 04/30/2021 10:42 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:YANEZ, SYLVIA FAMILY CHILD CAREFACILITY NUMBER:
376100691
ADMINISTRATOR:SYLVIA YANEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 245-9831
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/30/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Applicant Sylvia YanezTIME COMPLETED:
10:50 AM
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On 4/30/21 @ 10:05 a.m., Licensing Program Analyst, Joelle Redding, met with Applicant Sylvia Yanez, for the purpose of a Pre-Licensing inspection. This visit is being conducted virtually, due to Covid-19 restrictions. Applicant applied for a change of location on 3/9/2021.

LPA toured the home. It is one story with three bedrooms, two bathrooms and a two car garage. All required forms were posted. There is a working telephone on the premises. LPA did not note any hazardous items accessible to children. The fireplace is secured and there are no bodies of water or weapons/firearms or ammunition in the home or on the property. The fire extinguisher size (2A10BC or larger) meets requirements and is fully charged, located in the kitchen. The smoke detector (located in the living room and child care bedroom ) and carbon monoxide detector (located on the wall near the hallway) are operational. Applicant’s Pediatric CPR/FA certification with ABC is EMSA certified and is valid through 8/22. All adults living (Applicant's two adult brothers Jesus and or working in the home have been fingerprint cleared and associated and immunization requirements have been met. Control of property was verified.

Applicant will be using the following areas for childcare: Living room, hallway bathroom, kitchen/dining area for eating, one bedroom for sleeping and the backyard. Off limits areas of the home include the master bedroom and bath, spare bedroom/office and the two car garage. and have been made inaccessible with the use of a safety gate. Backyard is fully-fenced and equipped with age-appropriate play equipment and toys, in good condition with plenty of shade. Applicant was reminded of requirements for children’s records, child abuse reporting, unusual incident reporting, immunizations, criminal background clearance procedures and policies, posting requirements. Safe Sleep procedures and Incidental Medical Services. Applicant was reminded that walkers, exersaucers, bouncy seats, jumpers, drop side cribs and napping portables are not to be used for day care. Garage use and smoking during in or around day care areas is prohibited. Covid 19 resources were discussed and self assessment guide was completed and reviewed during today's visit.
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE: DATE: 04/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2021
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: YANEZ, SYLVIA FAMILY CHILD CARE
FACILITY NUMBER: 376100691
VISIT DATE: 04/30/2021
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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, an updated Plan of Operation that includes 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.

Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

No corrections are required. Upon final file review, the change of location will be granted and a new license will be sent for posting.

Due to Covid-19 restrictions, his report is being delivered for signature via email. Applicant's reply to the email will be considered confirmation of receipt.
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2021
LIC809 (FAS) - (06/04)
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