376101091-4-18-2022-51-CC-NDIZ-CDLNHM-20220418102858

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101091
Report Date: 04/18/2022
Date Signed: 04/18/2022 10:29:11 AM

Document Has Been Signed on 04/18/2022 10:29 AM - It Cannot Be Edited

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:	BOULES, HADEL FAMILY CHILD CARE		FACILITY NUMBER:	376101091
ADMINISTRATOR:	HADEL BOULES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 569-8246
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92021
CAPACITY:	14	CENSUS: 0	DATE:	04/18/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Hadel Boules		TIME COMPLETED:	10:45 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 4/18/2022 at 9:00AM, Licensing Program Analyst(LPA) Nancy Diaz conducted an announced Pre-Licensing inspection for a change of location with the applicant, Hadel Boules. This 4-bedroom, 3-bathroom two-story family home was toured and inspected to ensure an environment safe for the care and supervision of children. Fire clearance was received on April 13, 2022 from the El Cajon Fire Department for capacity of 14 children. Applicant maintains smoke detectors and fire extinguisher in the home that meets regulation requirements. All hazardous items were latched and secured under the kitchen sink and are out of reach of children. Mrs. Boules stated that she does not maintain any weapons. Applicant maintains a first aid kit in the home. 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. Mrs. Boules was advised that helper Shadah Tobya has not cleared CACI. Ms. Tobya must re-submit livescan to complete CACI process. Control of property was provided to the department via copy of mortgage statement. First Aid and CPR will expire on April 2024 and Preventative Health Practices course was completed on Dec. 15, 2019. Mrs. Boules completed the "Lead Poisoning Prevention" on March 22, 2022. Mandated Reporter Training was completed on April 4, 2022. The daycare children will have access to: living room, dining, kitchen, downstair bathroom and the gated/fenced front yard. Off limit areas are: Garage, all of second floor and backyard. There is a door that locks to the stairs that leads to the 2nd floor of the home. Mrs. Boules stated that she will ensure that this door is locked when daycare children are present.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

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: BOULES, HADEL FAMILY CHILD CARE	FACILITY NUMBER: 376101091
	VISIT DATE: 04/18/2022

NARRATIVE

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LPA reviewed the required children's forms with Mrs. Boules. All required postings were observed posted.

The new provider packet was also reviewed with the applicant including information on child abuse reporting, children’s records, immunizations, adults living or working in the home, SIDS, Incidental Medical Services, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed Shaken Baby Syndrome and California Megan's Law and LPA provided: www.meganslaw.ca.gov.
Applicant and LPA discussed COVID-19 guidelines and how to prevent spread of the virus. LPA provided Mrs. Boules copies of COVID-19 posters for posting. Applicant was provided COVID-19 resources and directed to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.

Applicant has met all immunization requirements per SB792 and have completed the AB1207 Mandated Reported Training. Applicant is reminded to make anything that reads, "Keep Out of Reach of Children" inaccessible to children.

Mrs. Boules was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

Mrs. Boules states that she will comply with all regulations and laws governing family child care homes and that she is financially secure to operate a family child care home for children. LPA reviewed this report with Applicant prior to obtaining her signature.

LPA discussed and provided applicant with the following: Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov and phone number (916) 654-1541.In addition, for common questions or questions regarding licensing requirements to contact the Child Care Licensing duty line at 619-767-2248.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

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: BOULES, HADEL FAMILY CHILD CARE	FACILITY NUMBER: 376101091
	VISIT DATE: 04/18/2022

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

LPA discussed the safe sleep regulations with Mrs. Boules 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 Mrs. Boules 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Corrections needed prior to licensure:
- Obtain and install a Carbon Monoxide detector.
- Install children's equipment in the front yard.

Capacity shall include children under age 10 who reside at the licensee’s home.

An exit interview was conducted with Mrs. Boules. A copy of this report and appeal rights were provided. Mrs. Boules shall contact this LPA when corrections are completed. Corrections are needed no later than 4/22/2022.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

LIC809 (FAS) - (06/04)

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