376100484-9-28-2021-51-CC-SCLA-C7APC3-20210928111116

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100484
Report Date: 09/28/2021
Date Signed: 09/28/2021 11:11:31 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:	WINN, LIBERTY FAMILY CHILD CARE		FACILITY NUMBER:	376100484
ADMINISTRATOR:	LIBERTY WINN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 435-5809
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	14	CENSUS: 0	DATE:	09/28/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Liberty Winn		TIME COMPLETED:	11:25 AM

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 09/28/2021 at 9:45AM, Licensing Program Analyst (LPA) Samantha Clenista conducted an unannounced random inspection. Upon arrival, LPA was greeted by Licensee, Liberty Winn. The home was toured and inspected to ensure an environment safe for the care and supervision of children. There were no children in care during inspection. Licensee stated that she has not had day care children present since July 16, 2021 due to being out of town. Licensee stated that she does plan to care for children in the next couple weeks. Licensee stated she would like to update the areas she will be using for childcare: Bedroom 3 and hallway bathroom. Off-limits areas include: kitchen, living room, garage, bedroom 1, bedroom 2, office and an additional bathroom. The home has a fully charged fire extinguisher size 2A10BC and smoke detector. No carbon monoxide detector was present during inspection. LPA observed there to be chemicals (i.e. Lysol wipes, hand sanitizer/soaps, nasal spray, aerosol spray, etc.) in the day care bathroom, kitchen/dining room area and living room. Children’s toys and play equipment are available and observed free of hazards. Licensee has a jacuzzi lcoated in backyard and is covered per regulation. Licensee also has a lagoon in the backyard which is made inaccessible via fencing per regulation which includes vertical metal panels which are more than 5 ft. tall with a self-latching gate that pulls away from the bodies of water. There is a working telephone/email address. Licensee states there are no firearms or other weapons in the home. Children records were reviewed for Emergency Information and were observed to be in compliance. There are no new adults living or working in the home over the age of 18 years. All adult residents have been cleared for criminal record and child abuse index clearances or exemptions. Pediatric CPR and First-Aid certificates are valid through 02/2022. Licensee's Mandated Reporter Training Certificate per AB1207 expires 07/07/2022. LPA reviewed the following with Licensee: Safe Sleep Regulation Concept Handout, Car Seat Law, reporting requirements, capacity limitations, supervision, clearances, emergency drills, mandated reporting, YMCA resources for success, SIDS, and Shaken Baby Syndrome. Licensee is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha Clenista	TELEPHONE: (619) 818-6740
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021

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 2

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: WINN, LIBERTY FAMILY CHILD CARE	FACILITY NUMBER: 376100484
	VISIT DATE: 09/28/2021

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
26
27
28
29
30
31
32

Licensee is aware that interference with a child’s daily functions, physical and mental abuse is not allowed. Licensee is reminded to make anything that reads, "Keep Out of Reach of Children" inaccessible to children.

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

No deficiencies observed in the areas inspected during today's inspection. However, see two Technical Violations on LIC9102. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed Licensee post notice of site visit. LPA reviewed this report with Licensee prior to obtaining her signature.

Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov.
Duty Officer: (619) 767- 2248, Monday thru Friday 8am-5pm.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha Clenista	TELEPHONE: (619) 818-6740
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2