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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376625483
Report Date: 03/20/2023
Date Signed: 03/20/2023 11:00:00 AM


Document Has Been Signed on 03/20/2023 11:00 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:NOBLE, GUADALUPE FAMILY CHILD CAREFACILITY NUMBER:
376625483
ADMINISTRATOR:GUADALUPE NOBLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 380-8692
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY:14CENSUS: 4DATE:
03/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensee Guadalupe NobleTIME COMPLETED:
11:05 AM
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On 3/20/2023 at 9:30 a.m.Licensing Program Analyst (LPA), Joelle Redding, made an unannounced visit for the purpose of an Annual Inspection. During this visit, there were 4 children in care, one under the age of 2 years. The facility is within ratio and capacity.

LPA toured the home. Primary child care areas are main living areas of the home and three bedrooms and the fully fenced backyard. The facility sketch on file has been updated to show the master bedroom and bathroom and the garage as off limits areas. They have been made inaccessible with the use a door knob cover. Kitchen and bathroom cabinets have been latched to secure any hazardous items. There are no weapons stored in the home or on the property. The pool is fully fenced, per regulation. The fence is in good repair and the self-latching gate is operational. The fireplace has been secured. The fire extinguisher is full and of adequate size and located on the wall by the kitchen. There is a smoke alarm in each of the bedrooms and a dual smoke/carbon on the hallway ceiling. All are operational. There is a written Disaster Plan on file. Emergency drills have not been conducted in the last six months. 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. Licensee belongs to the food program and provides all meals. 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. There are no school age children enrolled. The facility roster was not current today. Licensee's pediatric CPR/FA certificate with A-B-Cpr and Mandated Reporter Training is expired. Licensee is reminded that Mandated Reporter Training certificates are to be renewed every two years at the following website: www.mandatedreporterca.com.
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2023
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: NOBLE, GUADALUPE FAMILY CHILD CARE
FACILITY NUMBER: 376625483
VISIT DATE: 03/20/2023
NARRATIVE
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LPA discussed the safe sleep regulations 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. Licensee is reminded that infants may not be swaddled while in care and walkers, exersaucers, jumpers, bouncy seats, napping portables and drop sided cribs are not permitted for use. LPA provided a copy of the Safe Sleep regulation, a sample of sleep logs and form LIC 9227.

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. There are no sevices in place.

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 vehicles and car seats are not to use used for sleeping. . Capacity limitations were reviewed. LPA discussed California Megan's Law and the website was provided as follows: www.meganslaw.ca.gov

SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2023
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: NOBLE, GUADALUPE FAMILY CHILD CARE
FACILITY NUMBER: 376625483
VISIT DATE: 03/20/2023
NARRATIVE
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Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

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 information 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 Guadalupe Noble. Exit interview conducted and report was reviewed with the licensee.

See LIC 809D for deficiencies. Technical violations issues today.

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 AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 03/20/2023 11:00 AM - 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: NOBLE, GUADALUPE FAMILY CHILD CARE
FACILITY NUMBER: 376625483

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on conversation with the LIcensee, she has not completed an emergency drill within the past six months which poses a potential health, safety or personal rights risk to children in care.
POC Due Date: 04/07/2023
Plan of Correction
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Licensee states that she will complete an emergency drill and log it by the plan of correction date and send a copy of the log to LPA via email to verify correction.
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on conversation with Licensee, she does not keep a sleep log for Child #1 who is 21 months. This poses a potential health, safety or personal rights risk to children in care.
POC Due Date: 04/07/2023
Plan of Correction
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Licensee will start a sleep log, using the example LPA provided today, and will provide copies of this week's logs and continue to do so until the child turns two. Licensee states that she will be sure to document sleep checks for all incoming infants in the future. A copy of this week's sleep log will be sent to LPA by the plan of correction date to verify correction.
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: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5


Document Has Been Signed on 03/20/2023 11:00 AM - 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: NOBLE, GUADALUPE FAMILY CHILD CARE
FACILITY NUMBER: 376625483

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on conversation with Licensee, she has does not havea current EMSA certified FA/CPR certification which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/07/2023
Plan of Correction
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Licensee states that she will register for an in person or hybrid EMSA certified class by the plan of correction date and send a copy of the receipt for registration to LPA for verification of correction.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2023
LIC809 (FAS) - (06/04)
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