372018024-1-31-2022-51-CC-PMAA-CB832P-20220131165217

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 372018024
Report Date: 01/31/2022
Date Signed: 01/31/2022 04:53:37 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:	GORDON, BOBBIE FAMILY CHILD CARE		FACILITY NUMBER:	372018024
ADMINISTRATOR:	BOBBIE GORDON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 789-9732
CITY:	RAMONA	STATE: CA	ZIP CODE:	92065
CAPACITY:	14	CENSUS:	DATE:	01/31/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:19 AM
MET WITH:	Bobbie Gordon		TIME COMPLETED:	01:35 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	On 1/31/22 at 9:19am Licensing Program Analyst (LPA) Patrick Ma conducted an unannounced annual inspection with the Licensee. Upon arrival, LPA met with Licensee Bobby Gordon. Licensee was provided the Inspection Checklist (LIC 126). The 3 bedroom, 2 bathroom, one story home was toured and inspected to ensure an environment safe for the care and supervision of children. Upon arrival there were 7 children in care, 2 under the age of two years. Licensee was over capacity. 2 additional preschool children arrived during the inspection before the Licensee’s husband came home. At 9:45am, husband, Cary Gordon, came home during inspection. Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include living room, kitchen, dining room, office, bathroom 1 and backyard. Off limits areas include all 3 bedrooms, bathroom 2, garage, and basement and are inaccessible through use of gates in the hallway and locks accessing the garage from the backyard. The licensee has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. The gate is not fully fenced. Licensee was advised that visual supervision is required at all times during outdoor activities. LPA conducted child care quality management interview with the Licensee. The fire extinguisher and carbon monoxide detector meet requirements and are operational. All hazardous items need to be latched/locked and secured out of reach of children. There is no body of water on the property. Licensee states that there are no weapons in the home. First Aid and CPR certifications needs to pediatric EMSA approved. Licensee has required immunizations. Licensee Mandated Reporter Training certificate expires 7/12/23 and is reminded it must be completed every 2 years. Children’s and Staff records were reviewed.

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

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: GORDON, BOBBIE FAMILY CHILD CARE	FACILITY NUMBER: 372018024
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/31/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation was missing a smoke detector which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/11/2022
	Plan of Correction
1 2 3 4

Type B

Section Cited

CCR

102417(g)(4)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, this requirement was not meet as hazardous cleaning solution and over the counter medicine was accessible under the kitchen sink and kitchen cabinet which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/31/2022
	Plan of Correction
1 2 3 4	Hazardous materials and medicine was made inaccessible during the inspection.

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: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

LIC809 (FAS) - (06/04)

Page: 9 of 9

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: GORDON, BOBBIE FAMILY CHILD CARE	FACILITY NUMBER: 372018024
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/31/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102419(d)

Admission Procedures and Parental and Authorized Representative's Rights

(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on records review children files were incomplete, some files were missing LIC 282, LIC 9150, LIC 627, elementary school enrollment proof, and/or infant sleep log which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/11/2022
	Plan of Correction
1 2 3 4

Type B

Section Cited

CCR

102416.5(e)

Staffing Ratio and Capacity

(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation facility was over ratio. Licensee had 9 children, including 2 infants without assistant for under an hour. Assistant returned to the facility during the inspection which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/31/2022
	Plan of Correction
1 2 3 4	Assistant returned to the facilty during inspection meeting ratio requirments.

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: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

LIC809 (FAS) - (06/04)

Page: 6 of 9

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: GORDON, BOBBIE FAMILY CHILD CARE	FACILITY NUMBER: 372018024
	VISIT DATE: 01/31/2022

NARRATIVE

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Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA reviewed Covid-19 guidelines with Licensee and provided Covid-19 resources. LPA directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed the safe sleep regulations with licensee 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 licensee 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 licensee 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.

A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee was reminded that all adults 18 and over living or working in the home, 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 and provided Licensee with the following: child care advocates-email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

LIC809 (FAS) - (06/04)

Page: 7 of 9

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: GORDON, BOBBIE FAMILY CHILD CARE	FACILITY NUMBER: 372018024
	VISIT DATE: 01/31/2022

NARRATIVE

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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

See LIC809D for deficiencies cited.

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.

Exit interview conducted and report was reviewed with the licensee Bobbie Gordon. LPA provided notice of site visit and observed it being posted at the facility. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

LIC809 (FAS) - (06/04)

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