376300517-2-7-2023-10-CC-CHAN-CNTSSL-20230207130807

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376300517
Report Date: 02/07/2023
Date Signed: 02/07/2023 01:08:16 PM

Document Has Been Signed on 02/07/2023 01:08 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	DE LA CRUZ FAMILY CHILD CARE		FACILITY NUMBER:	376300517
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 7	DATE:	02/07/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:02 PM
MET WITH:	Grace De La Cruz		TIME COMPLETED:	01:13 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 February 7, 2023 at 12:02 PM, Licensing Program Analysts (LPAs) Cindy Hamilton and Nasha King arrived at the facility to conduct a pre-licensing inspection. The licensee is currently licensed at 865 La Strada Dr, Fallbrook, CA 92028, has applied to increase capacity to a large family childcare home and a fire clearance was granted 01/23/2023. Present during this inspection were: seven children, licensee Grace De la Cruz and husband Manuel De la Cruz. The home is tri-level with four bedrooms, four bathrooms, with attached garage. LPA toured the facility, inside and out with licensee and the following was observed and/or discussed: · Per licensee, off-limit areas include: master bedroom, second floor and garage · Normal hours of operation will be: Monday-Friday, 7:00 am – 5:00 pm · Smoke detectors and Carbon Monoxide detectors were tested by licensee during this inspection and were in working order. · The fire existinguisher met standards established by the State Fire Marshal. · All hazardous items were observed to be inaccessible. Storage of poisons and toxins are inaccessible to children and locked under kitchen sink. Sharp items including kitchen knives, are inaccessible and stored in cabinet on kitchen counter. Medicines are locked and stored in master bedroom. · Guns or weapons are stored in the closet, on the top shelf of the master bedroom observed by LPA King. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations. · Stairs are barricaded · The fireplace is properly screened · Clean, safe and age appropriate toys were observed · There is an in-ground pool and above ground spa with fence and gate which meet Title 22 regulations. Applicant understands all bodies of water including ponds, above ground pools and spas, in-ground pools and spas, and some fountains must be properly covered or fenced per title 22 regulations. The Department must be notified before and after installation of the bodies of water described. In addition, all wading pools

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: DE LA CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 376300517
	VISIT DATE: 02/07/2023

NARRATIVE

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or similar product must be emptied immediately after use and stored in an upright position when not in use.
· There were no toxic plants inside or outside the facility observed at this time
· The outside activity area consists of: age and size appropriate toys
· Verification of control of property is maintained by applicant
· Facility Sketch and Emergency Disaster Plan are posted
· Pediatric CPR and First Aid Card – expire July 2024
· Preventive Health and Safety training, including nutrition and lead components have been completed by licensee.
· Licensee, confirmed there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

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

Licensee was reminded all adults 18 and over living or working in the home, 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.

LPA discussed the safe sleep regulations with licensee, 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 licenseeof 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.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: DE LA CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 376300517
	VISIT DATE: 02/07/2023

NARRATIVE

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LPA reviewed with licensee, the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents 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 following reminders were reviewed with licensee during inspection:

- Title 22 Reporting Requirements and the Regional Office Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
-Fingerprint transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations858@dss.ca.gov
- The Duty Officer is available to answer questions Monday – Friday 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

The increase for a Large Family Child Care Home will be submitted for approval with a maximum capacity of 12, or 14 with parent notification.

Exit interview conducted and report was reviewed with licensee Grace De la Cruz.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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