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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376611214
Report Date: 03/28/2022
Date Signed: 03/28/2022 11:13:28 AM


Document Has Been Signed on 03/28/2022 11:13 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:MAXWELL, REBECCA & DANIEL FAMILY CHILD CAREFACILITY NUMBER:
376611214
ADMINISTRATOR:MAXWELL, REBECCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 419-9219
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY:14CENSUS: 2DATE:
03/28/2022
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Rebecca Maxwell TIME COMPLETED:
11:30 AM
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On 03/28/22 at 10:04 a.m., Licensing Program Analyst (LPA), Rajani Goudreau conducted a unannounced Case Management Non-Compliance inspection regarding a Non-Compliance Plan dated June 23rd, 2020 . Upon visit, LPA met with Licensee, Rebecca Maxwell and discussed the reason for the visit and proceeded to tour the facility. During the visit there were two children in care and licensees' minor son present in the home. Facility operates Monday through Friday, 24 hours.

During today's visit, LPA reviewed a sample of children's files, the facility roster and postings. LPA discussed the needed documents for the removal of co-licensee from the license. 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.

LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . LPA informed licensee in order to sign up for Quarterly Updates and PINs through our website. Please go to www.cdss.ca.gov and on the right side of your screen click on “Receive Important Updates”, put your email address in and choose which program(s) you would like to subscribe to and click “subscribe. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

No deficiencies issued during today's visit. The following reports were discussed and provided to licensee: LIC809, Appeal Rights (LIC9058) and Notice of Site Visit (LIC9213). Notice of Site Visit shall be posted for 30 days from today's date. Exit interview was conducted with licensee, Rebecca Maxwell.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:
DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2022
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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