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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370810636
Report Date: 07/11/2019
Date Signed: 07/11/2019 04:43:49 PM

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:DENNY, SHIRLEY FAMILY DAY CAREFACILITY NUMBER:
370810636
ADMINISTRATOR:DENNY, SHIRLEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 264-4159
CITY:SAN DIEGOSTATE: CAZIP CODE:
92102
CAPACITY:12CENSUS: 3DATE:
07/11/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
04:05 PM
MET WITH:Shirley DennyTIME COMPLETED:
04:50 PM
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Licensing Program Analyst (LPA) Selina Siao conducted a plan of correction inspection. Upon arrival, there were three children including two infants at the facility with licensee. Licensee has conducted a fire drill with the children on 05/22/2019 and an earthquake drill with the children in care 05/23/2019. Licensee completed the online mandated child abuse training on 05/27/2019 and was reminded to renew it every two years. Facility does not have any prohibited items at the facility.

The following corrections are still pending and Licensee requested additional time for the
following corrections:
  • Immunization record for TDAP, MMR and annual influenza (within the last 12 months or a statement declining the flu shot).

  • The safety latch under the right sink cabinet door in the bathroom is not latching property and needs to replace. (A picture of the correction shall be submitted to Analyst)

  • There is a new child that started this week and his name is not on the roster. An updated roster is needed.


The above corrections shall be submitted to Analyst within 15 days by 07/26/2019.


A notice of site visit was posted during today's inspection.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019
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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