376619438-8-19-2019-51-CC-VWIN-BF7RFR-20190819125934

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376619438
Report Date: 08/19/2019
Date Signed: 08/19/2019 12:59:45 PM

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:	CALDWELL, KIMBERLY FAMILY CHILD CARE		FACILITY NUMBER:	376619438
ADMINISTRATOR:	KIMBERLY CALDWELL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 328-9748
CITY:	SANTEE	STATE: CA	ZIP CODE:	92071
CAPACITY:	14	CENSUS: 12	DATE:	08/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Alma Ayala		TIME COMPLETED:	01:15 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	Licensing Program Analysts (LPAs) Vicky Williamson and Michael Morales-DeSilvestore conducted an unannounced annual random inspection. LPAs met with assistant Alma Ayala who was supervising 7 children, 2 of whom were under 24 months. Two of the children present were Licensee's own children, 1 child is 12 years of age. Also present was April Coker who was supervising 5 preschool children in the daycare room. Shortly after LPAs arrival, Licensee Kimberly Caldwell arrived at the facility. Licensee stated there are no new adults living in the home over the age of 18 years. A review of staff records on 8/19/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee has CPR/First Aid certifications valid through 1/2020, assistant Alma Ayala has CPR/First Aid valid through 1/2021 and April Coker has Basic Life CPR valid through 12/2020. Licensee understands that Pediatric CPR/First Aid is required per regulations. The last emergency disaster drill was conducted and documented on 6/7/19. Licensee and both assistants have completed Mandated Reporter AB 1207 training. This single level, 4 bedroom, 2 bathroom home was inspected. The following areas are used for day care: living room, kitchen, dining area, bedroom 3 "playroom,"bathroom 2 (hallway), enclosed patio/playroom, and fully fenced back yard area. Off limit areas include: bedroom 1 (master), bathroom 1 (inside of master), bedroom 2, bedroom 4, side yard and the garage. hey are made inaccessible to children by the use of door locks.Licensee updated facility sketch during time of inspection. Licensee is reminded to maintain visual supervision of children at all times. There is no fire place in the home. There is an operational fire extinguisher, smoke and carbon monoxide detectors in the home. Poisons, cleaning compounds, medications and other hazardous items were not inaccessible to children. LPAs observed shampoo, conditioner and razors accessible to children in the shower and bathtub area of bathroom 2 (hallway). LPAs observed a fence in need of a minor repair during time of inspection. The fence had a raised board and appeared to be leaning into the play area of the backyard. Licensee stated that the high winds recently pushed against the fence causing it to lean into the yard and be in need of repair. Licensee stated that the backyard will be off limits until the fence is repaired.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2019

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: CALDWELL, KIMBERLY FAMILY CHILD CARE	FACILITY NUMBER: 376619438
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/19/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/19/2019 Section Cited	1 2 3 4 5 6 7	Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
	8 9 10 11 12 13 14	Requirement was not met as evidenced by: LPAs observation of shampoo, conditioner and razors in the shower and bath tub area accessible to daycare children in bathroom 2 (hallway). This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2019

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: CALDWELL, KIMBERLY FAMILY CHILD CARE	FACILITY NUMBER: 376619438
	VISIT DATE: 08/19/2019

NARRATIVE

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Adequate heating and ventilation are provided for day care children. Children toys, games, and books are available. The home has a working telephone and email. Licensee states there are NO firearms or weapons in the home. Children’s records were reviewed, and licensee maintains a copy of the emergency information card in each child’s records. LPA advised licensee that any new/additional adults must be cleared prior to working or residing in home. Licensee updated facility roster and verified that all adults have been fingerprinted and associated to the facility. Any minor upon his/her 18^th birthday must be fingerprinted within 30 days.

LPA reviewed the following with licensee: SIDS, Shaken Baby Syndrome, car seat law, reporting requirements and Safe Sleep Regulation, and Effects of Lead Exposure. Licensee was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Licensee reminded that corporal punishment and smoking are not allowed in the day care.

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

Licensee and assistants had immunization records for Dtap and Influenza but immunization records for measles was not available for review during time of inspection. Immunization law (SB792) was discussed with Licensee. Licensee understands that anyone who provides care and supervision to the children must have immunization records maintained at the facility for: pertussis, measles, and influenza.

LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2019

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: CALDWELL, KIMBERLY FAMILY CHILD CARE	FACILITY NUMBER: 376619438
	VISIT DATE: 08/19/2019

NARRATIVE

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Licensee was advised to email visit www.ccld.ca.gov to sign up for Quarterly Updates and PINs. Just go to www.ccld.ca.gov and click on Child Care, go under Quick Links and Quarterly Updates, click on “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and click “subscribe.”

See LIC809D for issued deficiencies. LPA reviewed this report with Licensee and an exit interview was conducted. The licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed Licensee post notice of site visit.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2019

LIC809 (FAS) - (06/04)

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