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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629251
Report Date: 05/02/2024
Date Signed: 05/02/2024 12:23:41 PM

Document Has Been Signed on 05/02/2024 12:23 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:RODRIGUEZ, OLGA MARINA FAMILY CHILD CAREFACILITY NUMBER:
376629251
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
05/02/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Olga RodriguezTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On 05/02/2024 at 10:45 AM, Licensing Program Analyst (LPA) Dana Stevens conducted a case management inspection for the purpose of an increase in capacity. LPA met with the Licensee, Olga Rodriguez and was granted entry into the facility. Licensee accompanied LPA on a tour of the inside and outside of the facility. Four children, ages 1,1, 3, and 4 were present in the facility during this inspection. This facility is a single story, 4 bedroom, 2 bathroom house. The following areas are used for child care: daycare room, dining area, kitchen, living room, and hall bathroom. Off-limits areas are 4 bedrooms, office and garage. These areas are made inaccessible with door knob covers and door locks. The backyard is used for outdoor activities, licensee stated total supervision is provided.

The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. The licensee has toys, play equipment and materials available for children’s use. Licensee stated there are no weapons in the home. Licensee stated there are no bodies of water on the premises. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee’s First Aid and CPR certifications expire on 10/2025. Licensee has required immunization. Licensee completed Mandated Reporter Training AB 1207 on 01/2024. The fire clearance for 14 children was granted/received on 03/14/2024. The last fire and disaster drill was conducted and logged 12/23/2023. Children's files and children's roster were reviewed and found complete. LPA discussed required documentation for a child care assistant.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2024
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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: RODRIGUEZ, OLGA MARINA FAMILY CHILD CARE
FACILITY NUMBER: 376629251
VISIT DATE: 05/02/2024
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LPA discussed the maximum number of children for whom care shall be provided when there is an assistant provider in the home, including children under age 10 who live in the licensee's home and the assistant provider's children under age 10, shall be either: Twelve (12) children with no more than four of whom may be infants or Fourteen (14) children, with at least two of the children with 1 child enrolled in kindergarten and 1 child at least six years of age and no more than three infants. Licensee stated hours of operation will be changed to: M-F 24 hours a day.

Incidental Medical services (IMS) policy was discussed.
Licensee stated that Incident Medical Services are not being provided at this time. 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.

No deficiencies cited. No corrections are needed. A large license will be granted effective 05/02/2024.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
LIC809 (FAS) - (06/04)
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