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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376623733
Report Date: 06/22/2020
Date Signed: 06/22/2020 12:29:35 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/25/2020 and conducted by Evaluator Tyra Block
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20200325143939
FACILITY NAME:FRACE, KIM UYEN FAMILY CHILD CAREFACILITY NUMBER:
376623733
ADMINISTRATOR:KIM UYEN FRACEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 829-7462
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY:12CENSUS: 9DATE:
06/22/2020
UNANNOUNCEDTIME BEGAN:
11:18 AM
MET WITH:Kim Frace UyenTIME COMPLETED:
11:59 AM
ALLEGATION(S):
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Adult in the home smokes on the day care premises
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tyra Block conducted an unannounced complaint tele-inspection, due to COVID-19, to deliver the above complaint finding. The initial inspection was conducted by LPA on 4/6/20. Present at the facility is licensee with 9 day care children including 3 children under 2 years old,helper, and Licensee's husband. Throughout the course of investigation records were reviewed and interviews were conducted with licensee, helper, and several daycare parents.
On 4/29/20, Licensee's helper,stated that he does smoke outside of the home when children are present at the facility. A day care parent that was interviewed confirmed she has observed an adult smoking outside on multiple occasions in the area reported by the Reporting Party. Based on information obtained through interviews and records reviewed, LPA determined that the preponderance of evidence has been met. There is enough supporting information to prove the above allegation is SUBSTANTIATED.
The deficiency is being cited on the attached LIC 9099D. An exit interview was conducted with Licensee. Notice of Site Visit was emailed and will be posted for 30 days. Appeal Rights (1/16) were discussed and provided. Licensee will email confirmation acknowleding receipt of this report and Appeal Rights .
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Tyra BlockTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 51-CC-20200325143939
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: FRACE, KIM UYEN FAMILY CHILD CARE
FACILITY NUMBER: 376623733
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/22/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/29/2020
Section Cited
HSC
1596.795(a)
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Smoking: ordinance enforcement-1596.795(a) The smoking of tobacco in a private residence that is licensed as a family day care home shall be prohibited in the home and in those areas of the family day care home where children are present. This requirement was not met as evidenced by:
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Licensee will submit a written statement that smoking is prohibited on the premises of the family day care during the hours of operation as a family child care with an acknowledgement that secondhand smoke is harmful to children's health. Helper will not smoke on the premises of the family child care.
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Based on interviews, licensee's helper smoked on the premises of the family child care, outside in the front of the house, during the hours of operation while children were present during drop off and pick-up.
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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: Tyra BlockTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2020
LIC9099 (FAS) - (06/04)
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