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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100122
Report Date: 10/07/2021
Date Signed: 10/11/2021 08:47:24 AM

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:KEELO, JUNBUD FAMILY CHILD CAREFACILITY NUMBER:
376100122
ADMINISTRATOR:JUNBUD KEELOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 592-3148
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:14CENSUS: 3DATE:
10/07/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Licensee, Junbud Keelo TIME COMPLETED:
05:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs), Jennifer Lott and Leandra Dolliole conducted an unannounced Annual Licensing Inspection. LPAs were greeted at the front door by Licensee, Junbud Keelo and granted entry after identifying themselves and disclosing the purpose of their visit. Licensee's daughter Vivian Basaka provided translating services as licensee's primary language is Arabic. The licensee is using the following areas for daycare: Living room, bedroom #1, bathroom #1, kitchen and back yard. Off limit areas include: Garage (which does not have a permit), bedroom #2 & #3, bathroom #2, front yard. Business Hours are: 6am-10pm M-F. The facility currently has 3 children in care of which 1 was an infant. Licensee provided a copy of their current roster and is operating within the licensed ratio and capacity.

At 2:30pm, LPA tested the smoke detector located in the bedroom/hall and the carbon monoxide detector located in the kitchen. Both devices were functional.
Licensee advised there are no bodies of water on the premises and LPA did not observe any bodies of water on the premises. Licensee, Keelo advised there are no firearms or ammunition stored on the premises.

There are no open face heaters/fireplaces or stairs in the home. Storage for poisons, detergents, cleaning solutions, medications are locked and inaccessible to children. Outdoor play area is fenced and free of hazards. The last disaster/fire drill was conducted on 08/2021. The home is kept clean and orderly with heating and ventilation for safety and comfort. The home provides safe toys, play equipment and materials.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
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 6
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: KEELO, JUNBUD FAMILY CHILD CARE
FACILITY NUMBER: 376100122
VISIT DATE: 10/07/2021
NARRATIVE
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Children’s records contained emergency contact information and immunization records. All parents or representatives received a copy of the Family Child Care Home Notification of Parent’s Rights. Pediatric CPR and First Aid cards are current and will expire on 06/2023. The mandated Child Abuse Reporting as per AB1207 was waived as Arabic is their primary language. There is a working telephone and email address.

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.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: KEELO, JUNBUD FAMILY CHILD CARE
FACILITY NUMBER: 376100122
VISIT DATE: 10/07/2021
NARRATIVE
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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, deficiencies were observed and noted on the attached LIC 809D. Exit interview conducted and report was reviewed with Licensee, Junbud Keelo. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: KEELO, JUNBUD FAMILY CHILD CARE
FACILITY NUMBER: 376100122
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observations and interview, the licensee did not comply with the section cited above in that the crib was full of blankets, pillows and toys. Licensee stated that the infant sleeps with blankets in the crib. This poses a potential health & safety risk to persons in care.
POC Due Date: 10/21/2021
Plan of Correction
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Licensee states they will remove all items from the crib and submit a photo to licensing. Also licensee will complete the Individual Infant Sleeping Plan and Log by POC date via fax or email.
Type B
Section Cited
CCR
102425(h)
Infant Safe Sleep
Car seats shall only be used for transportation purposes and shall not be used for sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observations and interview, the licensee did not comply with the section cited above in 1:1 infants in care was kept in a car seat/stroller which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2021
Plan of Correction
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Licensee states they will purchase a pack and play or similar item in order to allow movement from the infant. Proof of purchase receipt and photo of equipment will be submitted to CCL via fax or email by POC date.
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: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2021
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: KEELO, JUNBUD FAMILY CHILD CARE
FACILITY NUMBER: 376100122
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's record review and interviews, the licensee did not comply with the section cited above in that they could not produce personnel records for 2:2 assistants. This poses a potential health and safety risk to persons in care.
POC Due Date: 10/21/2021
Plan of Correction
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Licensee states they will produce 2:2 complete personnel files for both assistants. Proof will be submitted to CCL via fax or email by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2021
LIC809 (FAS) - (06/04)
Page: 5 of 6