372012866-6-14-2023-51-CC-SVEO-CSSV4D-20230614160610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 372012866
Report Date: 06/14/2023
Date Signed: 06/14/2023 04:06:20 PM

Document Has Been Signed on 06/14/2023 04:06 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	HANSEN, GALE FAMILY CHILD CARE		FACILITY NUMBER:	372012866
ADMINISTRATOR:	GALE HANSEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(858) 792-5949
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92130
CAPACITY:	14	CENSUS: 10	DATE:	06/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Gale Hansen		TIME COMPLETED:	04:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA), Saraliz Velando conducted an unannounced Annual Licensing Inspection. LPA was greeted at the front door by Licensee, Gale Hansen. LPA was granted entry after identifying herself and disclosing the purpose of her visit. Also present was her helper, Virginia Callahan. Licensee is using the following areas for daycare: Family Room, Daycare Room, and Bathroom 1. The following areas are off-limits to children: Bedrooms 1-5, Living Room, Dining Room, Bathrooms 2-3, Kitchen, Front Yard, and Garage. These areas are inaccessible to children by baby safety gates and locked doors. The children are provided safe, healthful, and comfortable environment, furnishings, and equipment. Business Hours are Monday-Friday, 8:00am-5:30pm. LPA tested the smoke alarm in the Daycare room and the carbon monoxide detector combo located in the Dining room area and both are functional. There is a fire extinguisher in the Daycare area that meets regulations. LPA did not observe any bodies of water on the premises. Licensee stated there are no weapons or ammunition stored on the premises and LPA did not observe any. There is a fireplace in the Family room area that has been screened and inaccessible to children. Storage for poisons, detergents, cleaning solutions, medications are out of reach and inaccessible to children by safety latches or Off Limit Rooms. Licensee provides outdoor play in her Back Yard with constant supervision. Licensee provided a fire/disaster drill log that shows the last drill was conducted on 5/15/23. The home is kept clean and orderly with heating and ventilation for safety and comfort. There are Sleep Logs available for two infants on her roster under 2 years old. Pediatric CPR and First Aid card expires October 2023. Licensee provided proof of Mandated Reporter Training that expires May 2024. Immunizations are current for licensee and her helper. There is a working telephone and email address.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Saraliz Velando	TELEPHONE: 619-767-2221
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: HANSEN, GALE FAMILY CHILD CARE	FACILITY NUMBER: 372012866
	VISIT DATE: 06/14/2023

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Licensee or facility representative was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain 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 licensee or facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee for facility representative 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.

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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to: inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Based on today’s visit, no deficiencies were cited. Exit interview was conducted and report was reviewed with licensee, Gale Hansen. Copy of report and Appeal Rights was given. A notice of site visit was posted and must remain for 30 days.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Saraliz Velando	TELEPHONE: 619-767-2221
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

LIC809 (FAS) - (06/04)

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