376623213-8-17-2023-10-CC-JMRO-CUSPC2-20230817111112

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376623213
Report Date: 08/17/2023
Date Signed: 08/17/2023 11:12:09 AM

Document Has Been Signed on 08/17/2023 11:12 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	BERGGREN, CATHERINE FAMILY CHILD CARE		FACILITY NUMBER:	376623213
ADMINISTRATOR:	CATHERINE BERGGREN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 520-5212
CITY:	ESCONDIDO	STATE: CA	ZIP CODE:	92025
CAPACITY:	14	CENSUS: 0	DATE:	08/17/2023
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Catherine Berggren		TIME COMPLETED:	11:25 AM

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On August 17, 2023 at 9:20 am, Licensing Program Analyst (LPA) Jessica Rubio arrived at the facility to make the facility status active so that licensee may begin operating and also to conduct an annual 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 7:30 am – 4:30 pm

· Off-limit areas include: Entire second story, lower level and garage.

· The facility is licensed to have no more than 14 children as a large family child care. There were no children present at the time of inspection as facility has not yet reopened.

· A working telephone is present, and the current phone number is on file

· A fully charged fire extinguisher (2A:10BC) was observed. A smoke detector and carbon monoxide detector were present and tested by the Licensee during this inspection.

· Fireplace is properly screened to prevent access by children

· All hazardous items are stored inaccessible to children

· Toxins are locked and inaccessible to children in care.

· Weapons are not present on this date as stated by Licensee Catherine Berggren. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations

· Stairs are barricaded

· Clean, safe, and age-appropriate toys are provided

· Facility Sketch, Emergency Disaster Plan and Notification of Parent’s Rights poster are posted

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 255-4093
LICENSING EVALUATOR NAME: Jessica M Rubio	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BERGGREN, CATHERINE FAMILY CHILD CARE	FACILITY NUMBER: 376623213
	VISIT DATE: 08/17/2023

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· Documentation of fire and disaster drills is not on file as facility has been inactive. LPA reminded licensee of the requirement at least once every six months and to document.

· No bodies of water are present 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.

· Verification of control of property is on file.

· There are no employees at this time.

· Licensee’s Mandated Reporter Training was expired. A technical violation will be issued as licensee has been inactive.

· Licensee’s Pediatric CPR and First Aid Card expires on 10/19/2023

· Health & Safety Certificate - completed on 6/10/2012

· Resident and/or staff records were reviewed and all adults who require caregiver background checks have not received all required clearances and/or exemptions. An adult resident (A1) of the home has not received a full clearance. Licensee had A1's DOJ clearance letter on file however, A1 was not checked for Child Abuse Central Index (CACI). A technical violation is being issued as the facility has been inactive and had no clients since A1 began residing in the home. LPA informed licensee must have A1 re-fingerprinted and cleared prior to accepting children.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send them email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was reminded that all adults 18 and over, living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 255-4093
LICENSING EVALUATOR NAME: Jessica M Rubio	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BERGGREN, CATHERINE FAMILY CHILD CARE	FACILITY NUMBER: 376623213
	VISIT DATE: 08/17/2023

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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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

The Licensee was informed of their reporting requirements and was provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov

The Licensee can submit transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations858@dss.ca.gov

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200

There are no deficiencies being cited at this time.

During the exit interview, the Licensee Catherine Berggren, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 8/15/2023. Exit interview was conducted, and this report was reviewed with the Licensee Catherine Berggren. Appeal rights were discussed and provided during the exit interview. A notice of site visit will be emailed and must remain posted for 30 days.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 255-4093
LICENSING EVALUATOR NAME: Jessica M Rubio	TELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

LIC809 (FAS) - (06/04)

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