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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376621741
Report Date: 10/05/2023
Date Signed: 10/05/2023 12:03:58 PM

Document Has Been Signed on 10/05/2023 12:03 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:SALCEDO, BERTHA FAMILY CHILD CAREFACILITY NUMBER:
376621741
ADMINISTRATOR:BERTHA SALCEDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 267-9852
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
10/05/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Bertha SalcedoTIME COMPLETED:
09:15 AM
NARRATIVE
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On October 5th, 2023 at 8:35 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted an unannounced inspection regarding a deficiency observed during a complaint investigation. LPA advised Licensee Bertha Salcedo of the visit’s purpose and she granted LPA facility entry. Language Link Operator 16462 provided Spanish language translation services. Present in the home were six (6) children with the Licensee and one (1) helper.

The daycare is licensed for fourteen (14) children. Interviews with the Licensee, helpers, children, parents, and outside source witnesses were conducted. Documents were reviewed. Obtained time sheets documented that on 06/15/2023, from 8 AM to 2:20 PM, seventeen (17) children were present in the daycare.

The Licensee confirmed that seventeen children were simultaneously in the daycare on 06/15/2023. The Licensee states children have been disenrolled. The Licensee and LPA discussed capacity/ratio for large Family Child Care homes and the capacity/ratio flier was provided to Licensee.

A deficiency was observed as per California Code of Regulations, (Title 22, Division 12 & Chapter 3), and is being cited on the attached LIC 809-D.



AB633 requires upon receipt, Licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. An Acknowledgment of Receipt of Licensing Reports, Form LIC 9224 must be signed and placed in each child’s file. LPA provided Licensee with one blank LIC 9224 form.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: SALCEDO, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 376621741
VISIT DATE: 10/05/2023
NARRATIVE
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A notice of site visit was given to the licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Licensee/Appeal Rights (LIC 9058) was provided to Licensee Salcedo. Exit interview conducted and report was reviewed with the Licensee Bertha Salcedo.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/05/2023 12:03 PM - It Cannot Be Edited


Created By: JoAnn R Legaspi On 09/29/2023 at 01:11 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SALCEDO, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 376621741

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/20/2023
Section Cited
CCR
102416.5(f)

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(f) The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children.


This requirement was not met as evidenced by:

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Licensee has already disenrolled children. She said she will complete the online training about legal capacity on the childcarevideos.org website and provided a written statement about what they learned. LPA provided Licensee with a hard copy of CCR 102416.5 and the ratio/capacity worksheet. LPA and
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Based on conducted interviews and record reviews, the Licensee did not comply with the section cited above in that seventeen children were present in the daycare on 06/15/2023, which poses as an immediate health, safety, or personal rights risk to persons in care.
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Licensee reviewed these documents together. The Licensee agrees to provide LPA with a written statement acknowledging an understanding of this code section and legal capacity. Licensee also agrees to provide LPA with a written statement on how they will prevent over capacity no later than 10/20/2023.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Tulam Vu
LICENSING EVALUATOR NAME:JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:
DATE: 10/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/05/2023


LIC809 (FAS) - (06/04)
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