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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376613972
Report Date: 03/02/2020
Date Signed: 03/02/2020 03:43:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MAYER, TERESA FAMILY CHILD CAREFACILITY NUMBER:
376613972
ADMINISTRATOR:MAYER, TERESAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 419-0166
CITY:OCEANSIDESTATE: CAZIP CODE:
92056
CAPACITY:14CENSUS: 14DATE:
03/02/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:16 PM
MET WITH:Teresa MayerTIME COMPLETED:
03:50 PM
NARRATIVE
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(2) On date and time listed, Licensing Program Analyst (LPA) Otsanya Cameron arrived at the facility to conduct a 1-year required inspection as part of a compliance review. LPA toured the facility, inside and out, records were reviewed and the following was observed and/or discussed:
Normal days and hours of operation are: Monday Through Friday 5:30am to 5:00pm
OFF-LIMIT AREAS INCLUDE: Master bedroom and bathroom, Kitchen
· The facility is operating within the licensed capacity and appropriate ratios
· Appropriate supervision provided during inspection – when temporarily away from the home, the Licensee shall arrange for a substitute adult to care for and supervise children in their absence
· A working telephone is present
· Appropriate fire extinguisher is present.Smoke detector and carbon monoxide detector present but were not tested by the applicant during this inspection due to napping children.
· All hazardous items must be inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children SEE LIC 809-D
· Storage of poisons is inaccessible to children and locked
· No guns or weapons present as stated by the Licensee. LICENSEE UNDERSTANDS ALL GUNS, WEAPONS AND AMMUNITION MUST BE KEY-LOCKED SEPARATELY AND MADE INACCESSIBLE PER TITLE 22 REGULATIONS.
· This is a one story home
· Verification of control of property on file
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MAYER, TERESA FAMILY CHILD CARE
FACILITY NUMBER: 376613972
VISIT DATE: 03/02/2020
NARRATIVE
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· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted
· Pediatric CPR and First Aid Card expire on 9/22/2020 (Licensee) 6/16/2020( Assistant)
· Health & Safety Certificate - completed
· No bodies of water at this time. LICENSEE UNDERSTANDS ALL BODIES OF WATER INCLUDING PONDS, ABOVE GROUND POOLS & SPAS, IN-GROUND POOLS & SPAS, AND SOME FOUNTAINS MUST BE PROPERLY COVERED OR FENCED PER TITLE 22 REGULATIONS. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.

· The home is clean and orderly with proper heating and ventilation for safety and comfort
· Outside play area is properly fenced or the Licensee maintains appropriate supervision
· Roster on file
· Documentation of fire drills on file. Last conducted 10/25/2019
· Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed. Resident and/or staff records reviewed on 2/19/2020 indicate that all adults who require caregiver background checks have received all required clearances or exemptions.

· 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
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MAYER, TERESA FAMILY CHILD CARE
FACILITY NUMBER: 376613972
VISIT DATE: 03/02/2020
NARRATIVE
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- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov.
- Please subscribe at www.childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov
- The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

See LIC809D for cited deficiencies.

During the exit interview, the LICENSEE, Teresa Mayer, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS ALONG WITH A COPY OF ALL TYPE A DEFICIENCIES (LIC9099D) CITED DURING THIS INSPECTION. A COPY OF ALL TYPE A DEFICIENCIES CITED DURING THIS INSPECTION MUST ALSO BE IMMEDIATELY (WITHIN 24 HOURS OF THE CHILD’S NEXT DAY IN CARE) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS (AT THE TIME OF ENROLLMENT).

Appeal rights discussed and a copy of this report was provided to the licensee on this date and must be made available to the public upon request for the next 3 years.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MAYER, TERESA FAMILY CHILD CARE
FACILITY NUMBER: 376613972
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/02/2020
Section Cited

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 Operation of a Family Child Care Home. Items which could pose a danger to children shall be stored where they are inaccessible to children.

This requirement was not met as evidenced by:

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During inspectiion of outdoor play area, LPA observed an unlocked shed in the backyard. Licensee did not ensure the padlock on the shed was latched. LPA observed 5 Swords stored behind other tools and equipment inside the shed.
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Licensee states allowed her old neighbor to use shed as a storage temporarily during his recent move.There was supervision provided, and children were not playing near the shed during today's inspection.

This poses a potential risk to children in care.
Type B
03/13/2020
Section Cited

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Child's records
The licensee shall maintain, in each child’s record, the signed and dated notice form LIC 995A, Parents Rights Notice. This requirement was not met as evidenced by: LPA noted that there was no file for Children 1-4.
Type B
03/13/2020
Section Cited

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Immunizations
Licensee shall document and maintain each child’s immunizations as long as the child is enrolled.
This requirement was not met as evidenced by: Licensee did not ensure to have
immunization records on file for children 1-4
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: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2020
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MAYER, TERESA FAMILY CHILD CARE
FACILITY NUMBER: 376613972
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/03/2020
Section Cited

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102417(g)(4) Operation of a Family Child Care Home.
... items which could pose a danger to children shall be stored where they are inaccessible to children.

This requirement was not met as evidenced by:
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Licensee did not ensure kitchen knives were stored where inaccessible. LPA observed kitchen knives on the counter in the kitchen. There were 6 children 5 and under napping in the nearby daycare room and 8 Children outside in the backyard. ..............................
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The kitchen area is accessible to children.
This poses an immediate risk to chlildren in care

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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: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2020
LIC809 (FAS) - (06/04)
Page: 5 of 5