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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629962
Report Date: 10/21/2024
Date Signed: 10/23/2024 04:37:14 PM

Document Has Been Signed on 10/23/2024 04:37 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:NARANJO, JUAN FAMILY CHILD CAREFACILITY NUMBER:
376629962
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
10/21/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:36 PM
MET WITH:Elvia MartinezTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
NARRATIVE
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On 10/21/2024 at 12:36 pm, Licensing Program Analysts (LPAs) Adrian Castellon and Danielle Anderson conducted an unannounced initial 10-day complaint inspection. The LPAs met with facility assistant Eliva Martinez. Martinez permitted LPAs to tour the home, including off limits bedroom. There were no children in care.

During the inspection, LPAs became aware of deficiencies that did not pertain to the complaint inspection:

LIC9227 was not kept in child's file.

Licensee is not maintaining Safe Sleep Log (15 minute check).

Infants are slept on a matt on the floor and not in crib or playpen.

Violations of the California Code of Regulations, Tittle 22, are being cited on the attached LIC809D. Exit interview was conducted, report reviewed, and Appeal Rights discussed with Martinez. LPA informed Martinez and licensee Naranjo (via telephone)to provide a copy of this report that documents Type A citation to parents/guardians of children currently enrolled by the next business day or the next day children are in care, and to newly enrolled parents/guardians for 12 months from this date. LPA discussed LIC9224 process.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2024
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
Document Has Been Signed on 10/23/2024 04:37 PM - It Cannot Be Edited


Created By: Adrian Castellon On 10/21/2024 at 12:59 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: NARANJO, JUAN FAMILY CHILD CARE
FACILITY NUMBER: 376629962

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/21/2024
Section Cited
CCR
102425(a)

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102425 Infant Safe Sleep (a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. This requirement was not met as evidenced by licensee Naranjo and assistant Martinez admission that infants are not slept in cribs or playpens.
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Licensee states that playpens are kept in the home but not used. Licensee will use playpens for sleeping infants immediately.
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This poses an immediate threat to the health and safety of children in care.
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Type A
10/21/2024
Section Cited
CCR102425(j)(2)(D)

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102425 Infant Safe Sleep (j)(2)(D): The provider shall supervise infants while they are sleeping and adhere to the following requirements: (2) The provider shall check and document the following: (D) Documentation shall be maintained in the infant’s file and be available to the
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Licensee Naranjo will submit 15 minute Safe Sleep log for the period of 10/22/24 through 11/12/24 to the Regional Office on 11/13/24.
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Department for review. Documentation shall include the following: a. Date. b. Infant’s name. c.Time of each 15-minute check. This requirement was not met as evidenced by a facility staff failure to maintain 15 minute Safe Sleep log. This poses an immediate threat to the health and safety of children.
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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:Adrian Castellon
LICENSING EVALUATOR SIGNATURE:
DATE: 10/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/21/2024


LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 10/23/2024 04:37 PM - It Cannot Be Edited


Created By: Adrian Castellon On 10/21/2024 at 01:16 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: NARANJO, JUAN FAMILY CHILD CARE
FACILITY NUMBER: 376629962

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2024
Section Cited
CCR
102425(c)

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102425 Infant Safe Sleep (c) An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 month of age the provider has in care and maintained at the facility in the infant’s file. This requirement was not met as evidenced by a file review where
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Licensee will submit LIC9227 for the two infants in care to the licensing office by POC date.
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LIC9227 was not maintained for an infant. This may pose a threat to the health and safety of children in care.
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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:Adrian Castellon
LICENSING EVALUATOR SIGNATURE:
DATE: 10/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/21/2024


LIC809 (FAS) - (06/04)
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