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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627804
Report Date: 11/17/2021
Date Signed: 11/17/2021 03:28:31 PM

Document Has Been Signed on 11/17/2021 03:28 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:BLANCAS, DENISSE FAMILY CHILD CAREFACILITY NUMBER:
376627804
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Denisse Blancas, LicenseeTIME COMPLETED:
03:30 PM
NARRATIVE
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On November 17, 2021 at 1:15 PM, Licensing Program Analyst (LPA), Marie Hernandez conducted an unannounced Annual Required Inspection and met with the Licensee, Denisse Blancas. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. There were no children present during the inspection today. This facility is a one story, three bedroom, and two bath home. The Licensee accompanied LPA during the inspection of the home, inside and outside of the facility. The following areas are used for child care are: The kitchen, dining room, living room, hallway bathroom, day care rooms #1 & #2, and the backyard. The off limit areas inaccessible through use of a child safety gate and child proof door knobs. All hazardous items were inaccessible to children. The storage area for poisons is locked. The licensee has toys, play equipment and materials available. No bodies of water observed on the premises during the inspection. The Licensee stated there are no weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received a criminal record and child abuse clearances or exemptions. Licensee’s First Aid and CPR certification expired on 06/2020. The Licensees have the required immunization records. The Licensee's Mandated Reporter (AB1207) certification expired on 08/16/2018. The mandated reporter certification must be renewed every two years prior to expiration. The Licensee has not maintained the fire/disaster drills. The Licensee currently does not have any infants enrolled in the facility. However, LPA discussed and provided the Infant Safe Sleep plan, regulation and the fifteen minute checks information. LPA provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in day-care. Licensee was also provided with the information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. The handout was provided for he SDQPI Every Child Deserves Quality Early Learning Experiences.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Marie Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2021
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: BLANCAS, DENISSE FAMILY CHILD CARE
FACILITY NUMBER: 376627804
VISIT DATE: 11/17/2021
NARRATIVE
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LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

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.

LPA reviewed the following information with the Licensee: Safe Sleep, SIDS, shaken baby, child abuse reporting, community resources, YMCA Childcare Resource Service, children’s records, facility records, required postings, immunization's, unusual incident report, facility roster, car seat law, visual for ratio/capacity, fire/disaster drill log and prohibited items including no smoking or corporal punishment in a day care. LPA discussed the maximum capacity for a small family child care home: Maximum capacity: 6 - no more than 3 infants or 4 infants only. Capacity of 8 - No more than two infants, 1 child in kindergarten or elementary school and 1 child at least age 6, including children under age 10 who live in the home. Discussed and provided the Covid-19 postings. LPA discussed the Guardian for background checks and disassociation's with the Licensee.

The following deficiencies are cited on page 2 (LIC 809-D). An exit interview was conducted with the licensee. The licensee was provided a copy of the report, notice of site visit and the appeal rights. LPA observed the Licensee post the notice at the facility. The Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Marie Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 11/17/2021 03:28 PM - It Cannot Be Edited


Created By: Marie Hernandez On 11/17/2021 at 02:32 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: BLANCAS, DENISSE FAMILY CHILD CARE
FACILITY NUMBER: 376627804

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in which poses a potential health, and safety risk to persons in care. The Licensee stated she has not maintained the fire/disaster drills.
POC Due Date: 11/30/2021
Plan of Correction
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The Licensee stated she will conduct the fire/disaster drill with the children and will submit proof to LPA by November 30, 2021. The Licensee will maintain the drills and document the drills every six months as per regulations.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in which poses a potential health, and safety risk to persons in care. The Licensee's mandated reporter (AB1207) training certification expired on 08/16/2018.
POC Due Date: 11/30/2021
Plan of Correction
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The Licensee stated she will renew her mandated reporter training certification and will submit proof to LPA by November 30, 2021. The Licensee will comply by renewing her mandated reporter training every two years, prior to the expiration date.
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:Cynthia Gray
LICENSING EVALUATOR NAME:Marie Hernandez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2021


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 11/17/2021 03:28 PM - It Cannot Be Edited


Created By: Marie Hernandez On 11/17/2021 at 02:32 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: BLANCAS, DENISSE FAMILY CHILD CARE
FACILITY NUMBER: 376627804

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in which poses a potential health, and safety risk to persons in care. The Licensee's pediatric first aid/CPR expired on 06/2020.
POC Due Date: 11/30/2021
Plan of Correction
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The Licensee stated she will renew her first aid/CPR certification and will submit proof to LPA by November 30, 2021. The Licensee will maintain compliance by renewing her first aid/CPR certification prior to the expiration date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Cynthia Gray
LICENSING EVALUATOR NAME:Marie Hernandez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2021


LIC809 (FAS) - (06/04)
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