376621899-4-11-2023-51-CC-JREG-CQST99-20230411143133

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376621899
Report Date: 04/11/2023
Date Signed: 04/11/2023 02:31:46 PM

Document Has Been Signed on 04/11/2023 02:31 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:	GOYAL, PRATIBHA FAMILY CHILD CARE		FACILITY NUMBER:	376621899
ADMINISTRATOR:	PRATIBHA GOYAL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(858) 952-2908
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92129
CAPACITY:	14	CENSUS: 0	DATE:	04/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:25 PM
MET WITH:	Licensee Pratibha Goyal		TIME COMPLETED:	02:40 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	On 4/11/2023 at 1:25 p.m., Licensing Program Analyst (LPA), Joelle Redding, made an unannounced visit for the purpose of an Annual Inspection. During this visit, there were no children in care as it was Spring Break week. There are no infants in the program. Children start attending the Montessori based program at 3 years and potty trained. LPA toured the home. Primary child care areas are the child care room, downstairs bathroom, family room for quiet time or kitchen for supervised activity, and fully fenced back yard. The facility sketch on file is accurate. Off limits areas have been made inaccessible with the use of safety gates or other barriers. There are no weapons stored in the home or on the property and there are no bodies of water present. The fireplace has been secured and the stairs have been made inaccessible. The fire extinguisher is full and of adequate size and located in the foyer of the child care room. The smoke alarm (located on the ceiling by the child care room) and carbon monoxide detector (located in the family room) are operational. Emergency drills are being conducted and logged at least every six months and there is a written Disaster Plan on file. The last emergency drill was conducted in October of 2022. The home is clean, orderly with adequate ventilation and heating. Licensee has provided enough space for the children to eat, sleep and play within the home. Children bring their snacks and lunches in labeled containers and there is refrigeration available for storage, if needed. The furniture, to include napping materials and children’s toys, books and activities are safe and age appropriate and in good repair. Licensee has checked for recalled items. There is a working telephone and all required forms are posted. Outdoor play space is fully fenced with age appropriate play equipment and activities in good repair. No hazards were noted. Licensee understands there is no smoking in or around day care areas. Children’s files were reviewed and found to be complete. Verification that school age children present are enrolled/attending elementary or above was on file. The facility roster was current and complete and is being stored for 3 years.

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

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: GOYAL, PRATIBHA FAMILY CHILD CARE	FACILITY NUMBER: 376621899
	VISIT DATE: 04/11/2023

NARRATIVE

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Licensee's pediatric CPR/FA certificate with A-B-Cpr is valid through 2/24. Staff files were reviewed and found to be current. Licensee is reminded that Mandated Reporter Training certificates are to be renewed every two years at the following website: www.mandatedreporterca.com. Licensee and her assistant have current certificates.

Children will be observed upon entry and throughout the day for signs of illness. An appropriate isolation area has been established for sick children. Reporting requirements for positive Covid-19 results in children or staff were discussed to include contact with County Department of Public Health for guidance (619-692-8499) and Licensing (619-767-2248) to report the unusual incident for THREE or more cases.

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. Licensee will be submitting a Plan for approval as there is a child enrolled with a peanut allergy and EpiPen.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a 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.

Licensee is to be present in the home to ensure children are supervised and reminded that no children are to be left in parked vehicle. Capacity limitations were reviewed. LPA discussed California Megan's Law and the website was provided as follows: www.meganslaw.ca.gov

Licensee is signed up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov.

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

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: GOYAL, PRATIBHA FAMILY CHILD CARE	FACILITY NUMBER: 376621899
	VISIT DATE: 04/11/2023

NARRATIVE

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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 formation regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

LPA conducted child care quality management interview with Licensee Prathibha Goyal. Exit interview conducted and report reviewed with the licensee.

No deficiencies are cited.

NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023

LIC809 (FAS) - (06/04)

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