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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334830616
Report Date: 11/09/2020
Date Signed: 11/09/2020 09:09:46 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:BELL FAMILY CHILD CAREFACILITY NUMBER:
334830616
ADMINISTRATOR:BELL, SONDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 229-5208
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY:14CENSUS: DATE:
11/09/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Sondra BellTIME COMPLETED:
08:45 AM
NARRATIVE
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On November 9, 2020 at 8:35 AM, Due to COVID-19, Licensing Program Analyst (LPA) Yolanda Jackson conducted a Tele-Inspection Case Management Visit with Licensee, Sondra Bell. The LPA observed the following deficiency: The Licensee’s Assistant is fingerprint cleared but is not associated to the facility. The Licensee’s Assistant has worked at the facility since March, 2019.

A deficiency is being cited based on the LPA observation and interview conducted in accordance with the California Code of Regulations, Title 22, See 809D. A violation regarding Criminal Record Clearance, an immediate civil penalty $500 will be assessed, see 421B. An exit interview was conducted. A copy of this report and appeals rights were discussed and left with the Licensee, Sondra Bell.

The Notice of Site of Visit and Type A Deficiencies from today’s visit must be posted for 30 days. Failure to keep these posted for the entire 30 days will result in an immediate $100 civil penalty penalty for each.

**Continued on next page**

SUPERVISOR'S NAME: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Yolanda JacksonTELEPHONE: (951) 201-1991
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: BELL FAMILY CHILD CARE
FACILITY NUMBER: 334830616
VISIT DATE: 11/09/2020
NARRATIVE
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A NOTICE OF SITE VISIT WAS NOT LEFT AT THE FACILITY DUE TO THIS BEING A TELE-INVESTIGATION.

An exit interview was conducted, and a copy of this report was provided to Licensee on this date. Due to COVID-19 State of Emergency, LPA provided a copy of this report via email with an electronic “READ RECEIPT”. LPA Jackson requested Licensee to acknowledge receipt of the email. The electronic read receipt of the emailed report acknowledges receipt of this report. Licensee understands that a copy of this report must be made available to the public, upon their request, for the next three years.”

SUPERVISOR'S NAME: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Yolanda JacksonTELEPHONE: (951) 201-1991
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BELL FAMILY CHILD CARE
FACILITY NUMBER: 334830616
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/03/2020
Section Cited

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CRIMINAL RECORD CLEARANCE. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 102370(j).
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This requirement was not met as evidenced by: The Licensee's assistant is fingerprint cleared, but is not associated to the facility. The Licensee's Assistant has worked at the facility since March, 2019.
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Based on observation and interview which poses an potential Personal Rights risk to persons 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: Telma SandovalTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Yolanda JacksonTELEPHONE: (951) 201-1991
LICENSING EVALUATOR SIGNATURE:
DATE: 11/06/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2020
LIC809 (FAS) - (06/04)
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