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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376614787
Report Date: 03/24/2022
Date Signed: 03/24/2022 02:29:04 PM


Document Has Been Signed on 03/24/2022 02:29 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:REJANE, MINNIE FAMILY CHILD CAREFACILITY NUMBER:
376614787
ADMINISTRATOR:MINNIE REJANEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 219-7287
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY:14CENSUS: 9DATE:
03/24/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:Minnie RejaneTIME COMPLETED:
02:45 PM
NARRATIVE
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On 03/24/2022 at 1:31pm, Licensing Program Analyst, Samantha Clenista, became aware of a regulatory violation during the course of an unrelated visit. Upon arrival LPA met with Licensee, Minnie Rejane. Also present were 9 children (1 who is an infant), and two helpers (Daniela Carvalho and Maria Arrieta Pena). Upon inspecting the facility, LPA observed a jacuzzi in the backyard. Jacuzzi was observed to be appropriately latched on four sides and in good repair. LPA noticed that there was no mention of a jacuzzi in the file or notification from the Licensee of getting a jacuzzi. Licensee stated that she had just purchased and installed the jacuzzi in December 2021. Licensee stated that she was not aware of the requirement to report to it Child Care Licensing.

See 809D for cited deficiency. Due to printer malfunction, LPA emailed Notice of Site Visit poster, this report, appeal rights and reporting requirement regulation to Licensee at conclusion of visit. NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha ClenistaTELEPHONE: (619) 818-6740
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
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 03/24/2022 02:29 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: REJANE, MINNIE FAMILY CHILD CARE
FACILITY NUMBER: 376614787

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/25/2022
Section Cited

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Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the installation of in-ground or above-ground swimming
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pools, spas, fish ponds, decorative water feature, fountains or other bodies of water. This requirement was not met as evidenced by, Licensee installed an above ground jacuzzi back in December 2021, however, did not notify the CCL. This poses a Potential Health and Safety risk to the clients 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha ClenistaTELEPHONE: (619) 818-6740
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
LIC809 (FAS) - (06/04)
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