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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629308
Report Date: 05/17/2022
Date Signed: 05/17/2022 11:54:53 AM

Document Has Been Signed on 05/17/2022 11:54 AM - 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:BARBOSA, LIGIA FAMILY CHILD CAREFACILITY NUMBER:
376629308
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/17/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Ligia Barbosa, ApplicantTIME COMPLETED:
11:55 AM
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On May 17, 2022, at 9:30 AM., Licensing Program Analyst (LPA) Marie Hernandez conducted an announced pre-licensing inspection with the applicant, Ligia Barbosa and her spouse, Javier Rodriguez. The spouse provided translation services for the Applicant in Spanish. The purpose of the inspection is to ensure that the home complies with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes.

This is a one story four bedroom, two bath home that was toured and inspected to ensure the environment is safe for the care and supervision of children. The applicant provided proof of control of the property for review by the Department. The applicant will use the following areas for childcare: Kitchen, dining room, living room, hallway bathroom and the backyard patio The off-limit area include the garage, bedrooms #1 through #4 including the attached bathroom, and the side of backyard. They are made inaccessible to day care children through the use of a child proof doorknob covers and door locks. The Applicant will utilized backyard patio only for outdoor activities of children. The Applicant stated it is understood that there must always be direct supervision while outdoors with the children. There are no bodies of water observed during the time of visit. The applicant stated there are no weapons or firearms in the home. The fire extinguisher, smoke detector and carbon monoxide detector meets the requirements and are operational. All poisons, cleaners, and hazardous items in the home are inaccessible to children through latches, locks, and/or placed on high surfaces. The children’s toys and play equipment are available. The applicant has completed the Eight Hours of Preventative Health. Pediatric CPR and First Aid certifications expire on 03/2024. The Mandated Reporter AB1207 training certification expires 06/30/2023 and must be renewed every two years prior to expiration date. The immunization records per SB792 were reviewed and are incompliance. The operating hours are Monday through Friday from 7:00 AM to 5:00 PM. The applicant was advised that no changes should be made to the home without prior notice and/or approval from Licensing. The Applicant states they are financially secure to operate a family childcare home for children and will comply with all regulations and laws governing family childcare homes.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Marie Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022
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: BARBOSA, LIGIA FAMILY CHILD CARE
FACILITY NUMBER: 376629308
VISIT DATE: 05/17/2022
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The applicant currently does not plan on providing IMS to clients. 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 the publication: Commonly Asked Questions about Family Child Care and the ADA, available at: http://www.ada.gov/childqanda.htm.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. 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.

Effective today, 05/17/2022, the Applicant is approved for licensure. The facility license will be mailed to the Applicant. Exit interview conducted and report was reviewed with the Applicant, Ligia Barbosa.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Marie Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2022
LIC809 (FAS) - (06/04)
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