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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376612193
Report Date: 03/07/2024
Date Signed: 03/07/2024 02:54:31 PM

Document Has Been Signed on 03/07/2024 02:54 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:GOMEZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
376612193
ADMINISTRATOR:GOMEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 445-7385
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 9DATE:
03/07/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Licensee, Maria GomezTIME COMPLETED:
03:05 PM
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Licensing Program Analyst (LPA), Saraliz Velando conducted an unannounced Annual Licensing Inspection. LPA was greeted by licensee, Maria Gomez. LPA was granted entry after identifying herself and disclosing the purpose of the visit. There were 9 children in care. Licensee is using the following areas for daycare: living room, family room, dining room, kitchen, bedroom #1, bedroom #2, bedroom #3, bathroom #2 (hallway bathroom), bathroom #3 (family room bathroom) and enclosed backyard. Off-limits areas include: bathroom #1 (located in bedroom #1) and garage.

There are no weapons stored in the home or on the property and there are no bodies of water present. There is a fireplace that has been screened and made inaccessible to children. The fire extinguisher meets regulations and is located in the kitchen. The smoke alarm and carbon monoxide detector is functional and located in the hallway. The home is clean, orderly and has adequate ventilation and heating. Storage for poisons, detergents, cleaning solutions, medications are inaccessible by safety latches or out of reach. Licensee’s last fire drill was conducted on 3/6/24.

Pediatric CPR and First Aid card for provider will expire January 2025. Licensee’s Mandated Reporter Training certificate expires May 2024. There is a working telephone and email address.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GOMEZ, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 376612193
VISIT DATE: 03/07/2024
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share Licensee or facility representative was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain 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 or facility representative 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 licensee for facility representative 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.

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.htmyour inspection experience. If you have any questions regarding the process or tools, please send them by email to: inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

There were no deficiencies cited today.

Exit interview was conducted and report was reviewed with licensee, Maria Gomez. Copy of report and Appeal Rights was given. A notice of site visit was posted and must remain for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024
LIC809 (FAS) - (06/04)
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