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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100124
Report Date: 11/02/2021
Date Signed: 11/02/2021 11:20:16 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:HAZLETT, SHAYNA FAMILY CHILD CAREFACILITY NUMBER:
376100124
ADMINISTRATOR:SHAYNA HAZLETTFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 456-2680
CITY:EL CAJONSTATE: CAZIP CODE:
92020
CAPACITY:14CENSUS: 4DATE:
11/02/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Shayna HazlettTIME COMPLETED:
11:30 AM
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On November 2, 2021 at 8:50 a.m. Licensing Program Analyst (LPA), Leilani Curtis conducted an unannounced Annual Inspection and met with Licensee, Shayna Hazlett. LPA provided the LIC 126, Entrance Checklist to Licensee. There were four children in care, one who is an infant. At 11:00 a.m. the Licensee's helper Mikayla Cristini arrived at the facility. Facility was observed operating within ratio and capacity. LPA conducted a tour of the home inside and outside per facility sketch. Licensee is using the following areas for daycare: living room, dining area, kitchen, family room (playroom), bedroom #2, bathroom #2 and enclosed rear yard. Off-limits areas include: bedroom #1, bathroom #1, entire upstairs and garage.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Home is clean, orderly and has adequate ventilation. Children’s toys and play equipment are available and observed free of hazards. Stairs are barricaded. There is a working telephone/email address. All cleaning compounds, detergents, medications, and poisons are made inaccessible through latches, locks, and/or placed up on high surfaces. The fireplace is screened. The fire extinguisher and smoke and carbon monoxide detector are operational. Licensee states there are NO firearms or other weapons in the home. The outdoor play area is fenced. There is a swimming pool in the rear yard that is inaccessible to children by covering which supports the weight of an adult. The pool is also surrounded by a fence. Children records were reviewed for Emergency Information. There are no new adults living or working in the home over the age of 18 years. All adult residents and helpers have submitted or been cleared for criminal record and child abuse index clearances or exemptions. Pediatric CPR and First-Aid certificates are valid through 10/21/23. Licensee has completed the Mandated Child Abuse Reporting-per AB1207. LPA reviewed certification and it is in compliance. Immunization records per SB792 were reviewed and are in compliance.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021
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: HAZLETT, SHAYNA FAMILY CHILD CARE
FACILITY NUMBER: 376100124
VISIT DATE: 11/02/2021
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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.

LPA reviewed the following with Licensee: Recently Approved Safe Sleep Regulations PIN 20-24-CCP, Updated Coronavirus 2019 Industry Guidance PIN 21-18-CCP, California Department of Public Health Guidance for Child Care Providers dated 6/29/21, Car Seat Law and SIDS. Licensee is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation. Licensee is aware that interference with a child’s daily functions, corporal punishment, physical and mental abuse is not allowed. Licensee is reminded to make anything that reads, "Keep Out of Reach of Children" inaccessible to children. LPA also provided the following informational links about Child Development and Children’s Behavior and Food Allergies:

https://www.first5california.com/en-us/videos/from-the-experts-watch-me-learn-watch-me-grow/

https://emsa.ca.gov/childcare-nutrition/

No deficiencies cited.

SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021
LIC809 (FAS) - (06/04)
Page: 2 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: HAZLETT, SHAYNA FAMILY CHILD CARE
FACILITY NUMBER: 376100124
VISIT DATE: 11/02/2021
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Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website. Please go to www.ccld.ca.gov and click on Child Care, go under Quick Links and Quarterly Updates, click on “Receive Important Updates” then enter your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

Duty Officer: (619) 767- 2248, Monday thru Friday 8am-5pm.

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/process.

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 the safe sleep regulations with licensee 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 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee.

SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3