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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629134
Report Date: 07/08/2024
Date Signed: 07/08/2024 02:54:47 PM

Document Has Been Signed on 07/08/2024 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ZAVALA, SALINA FAMILY CHILD CAREFACILITY NUMBER:
376629134
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
07/08/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Licensee, Salina ZavalaTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 07/08/2024 at 12:30pm, Licensing Program Analyst (LPA), Shannan Williams conducted an unannounced Case Management-licensee initiated inspection with licensee, Salina Zavala, LPA Williams informed licensee that the purpose of the inspection was for the requested change of capacity. Licensee led LPA on a tour of the facility. There were zero (0) children and one (1) staff member at the facility during the time of the inspection. Hours of operation are Monday through Friday 5:30am – 5:00pm.

On 05/08/2024 a fire clearance was granted for fourteen (14) children. Licensee will use the following areas for childcare: kitchen, living room, daycare room, bathroom #1, backyard play area (fenced). Off Limit areas include: Bedroom #1, Bedroom #2, Bedroom #3, Entire Upstairs including Bedroom #4 and storage area, bathroom #2, Bathroom #3, Garage, Backyard non-off limit area. Off limit areas are inaccessible to children by use of safety gates, safety latches or doorknob covers. The fireplace located in the living room is securely screened. Licensee utilizes the fenced back yard for outdoor activities. LPA informed licensee to ensure children are supervised at all times during outdoor activities. LPA observed a decorative fountain in the off-limit area of the backyard. Licensee stated that the fountain is turned off during daycare hours of operation and fountain self-drains when not in use and when in use as well..
There are sufficient age-appropriate toys, games, and play equipment available. The home was clean and orderly during inspection. Detergents, cleaning compounds, and medicines are inaccessible to children in care and poisons are to be locked away. The fire extinguisher is rated 2A:10B:C and located in the daycare room, smoke alarm and carbon monoxide detectors meet requirements and are operational. There is a working cell phone in the home. Licensee stated there are no firearms, other weapons or ammunition on the property.

Licensee maintains documentation of proof of control of property for review by the Department. Property is owned by Licensee. .
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE: DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2024
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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ZAVALA, SALINA FAMILY CHILD CARE
FACILITY NUMBER: 376629134
VISIT DATE: 07/08/2024
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Licensee’s Mandated Reporter AB1207 training and expires on 07/2026. Pediatric CPR and First Aid certifications expire on 07/2025. Immunization records per SB792 were reviewed and met regulations. Required documents are posted.

All adults living or working in the home have been fingerprint cleared and associated. Facility roster was available and updated. A total of eight (5) children are currently enrolled. Children's files were reviewed and found complete. The last fire and disaster drill were conducted and documented on 06/3/2024.

There is one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. The provider physically checks on sleeping infants every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age. The provider places infants up to 12 months of age on their backs for sleeping.

LPA reviewed the following with licensee: SIDS, car seat law, reporting requirements, shaken baby syndrome, care and supervision, and COVID-19 precautions/guidelines. Licensee was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care.

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 licensee 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.

Licensee was reminded that 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.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ZAVALA, SALINA FAMILY CHILD CARE
FACILITY NUMBER: 376629134
VISIT DATE: 07/08/2024
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Incidental Medical Services (IMS) policy was discussed. 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 with applicant the LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

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. San Diego Regional Office Duty Line was provided: (619) 767-2248.

The maximum capacity for a Large Family Child Care home: 12 children (with a qualified assistant) with no more than 4 infants; or (with landlord consent) 14 children (with a qualified assistant) with no more than 3 infants, 1 child enrolled in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. When there is no qualified assistant, 14 years of age or present, the capacity reverts to the requirements for a Small Family Child Care.

There were no deficiencies cited during today's inspection.


Increase in capacity was granted on 07/08/2024

Exit interview conducted and report was reviewed with licensee, Salina Zavala. A copy of this report, along with Appeal Rights (LIC9058), were provided. A notice of site visit was given and must remain posted for 30 days. LPA observed that the notice of site visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
LIC809 (FAS) - (06/04)
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