376610033-4-7-2022-51-CC-SVEO-CD9R4L-20220407124144

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376610033
Report Date: 04/07/2022
Date Signed: 04/07/2022 12:42:00 PM

Document Has Been Signed on 04/07/2022 12:42 PM - 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:	HILL, JACQUELINE FAMILY CHILD CARE		FACILITY NUMBER:	376610033
ADMINISTRATOR:	JACQUELINE HILL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 561-9615
CITY:	LAKESIDE	STATE: CA	ZIP CODE:	92040
CAPACITY:	14	CENSUS: 7	DATE:	04/07/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Licensee, Jacqueline Hill		TIME COMPLETED:	12:50 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	At 10:00am, Licensing Program Analysts (LPAs), Saraliz Velando and Jennifer Lott conducted an unannounced Annual Licensing Inspection. LPAs were greeted at the front door by Jacqueline Hill and granted entry after identifying themselves and disclosing the purpose of their visit. Licensee’s helper, Allisa Carmona, was also present. The licensee is using the following areas for daycare: Kitchen, Family Room, Bathroom 3, Back patio. Off limit areas include: Dining room, Living room, Porch, Bedroom 4, Master bedroom, Master bathroom, Bedroom 2, Bedroom 3. Business Hours are: Monday- Friday, 6:30am-4:30pm. The facility currently has 7 children in care and is operating within the licensed ratio and capacity. LPA tested the smoke alarm and carbon monoxide detector located in the hallway area. Both devices were functional. LPA observed the swimming pool located in the backyard. All bodies of water are secured and meet Title 22 regulations with fencing measuring 5ft in height, not obscuring the pool from view. Licensee, Jacqueline Hill, stated there are no firearms or ammunition stored on the premises. Fireplace is screened to prevent access by children. There are children less than 5 years old are in care and stairs are gated. Storage for poisons, detergents, cleaning solutions, medications are latched and inaccessible to children. Outdoor play area is fenced and free of hazards. The last disaster/fire drill was conducted in January 2022 . The home is kept clean and orderly with heating and ventilation for safety and comfort. The home provides safe toys, play equipment and materials. 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 4/25/23. Mandated Child Abuse Reporting as per AB1207 expired 2/15/20. Staff immunizations were reviewed and in compliance. There is a working telephone and email address.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Saraliz Velando	TELEPHONE: 619-767-2221
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022

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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Document Has Been Signed on 04/07/2022 12:42 PM - It Cannot Be Edited

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: HILL, JACQUELINE FAMILY CHILD CARE	FACILITY NUMBER: 376610033
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/07/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in that the Mandated Reporter certificate expired on 2/15/2020, which poses a potential health and safety risk to persons in care.
	POC Due Date: 04/22/2022
	Plan of Correction
1 2 3 4	Licensee states that she will complete Mandated Reporter training and turn in certificate of completion by POC date. Licensee will submit by fax or email.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Saraliz Velando	TELEPHONE: 619-767-2221
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022

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: HILL, JACQUELINE FAMILY CHILD CARE	FACILITY NUMBER: 376610033
	VISIT DATE: 04/07/2022

NARRATIVE

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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 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.

This facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies., and reviewed children’s personnel and administrative records. For IMS information, see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.

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 the licensee, Jacqueline Hill. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Saraliz Velando	TELEPHONE: 619-767-2221
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022

LIC809 (FAS) - (06/04)

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