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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626282
Report Date: 07/12/2022
Date Signed: 07/12/2022 02:04:18 PM


Document Has Been Signed on 07/12/2022 02:04 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:DELIA, NICOLE FAMILY CHILD CAREFACILITY NUMBER:
376626282
ADMINISTRATOR:NICOLE DELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 741-7288
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY:14CENSUS: 11DATE:
07/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Nicole DeliaTIME COMPLETED:
02:08 PM
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Licensing Program Analyst (LPA), Tyra Block, conducted an unannounced annual inspection with the Licensee. Upon arrival LPA met Nicole Delia. Present were 11 children, licensee's spouse, and helper. The home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher (2A10BC), carbon monoxide detector, and smoke detector meet requirements and are operational. All hazardous items were inaccessible and secured out of reach of children. There are no bodies of water in the home. Licensee states that there are no weapons in the home. First Aid and CPR certifications expire on 10/2022. Mandated Reporter Training certification expires 8/2023. Licensee and helpers meet immunization requirements. Licensee maintains a current roster and is conducting emergency/disaster drills according to regulation. Last drill was conducted on 7/1/22. The fireplace located in the living room is properly barricaded/ screened.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include living room, kitchen/ dining room, hall bathroom, bedrooms #1 and #2, and backyard. Off limits areas include master bedroom, storage closets, and garage and are made inaccessible through use of doorknob covers.

Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, ensure that all adults living or working in the home have criminal background clearances to avoid civil penalties associated with this requirement; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. Licensee was also provided with information regarding SIDS and Shaken Baby Syndrome, Effects of Lead and Coronavirus Guidance for Preschool Settings. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra BlockTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/12/2022
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: DELIA, NICOLE FAMILY CHILD CARE
FACILITY NUMBER: 376626282
VISIT DATE: 07/12/2022
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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.

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.
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.


Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Applicant was encouraged to subscribe.

Applicant is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for forms and updated regulation information. Duty Line was provided: (619) 767-2248. Southern California Child Care Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra BlockTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: DELIA, NICOLE FAMILY CHILD CARE
FACILITY NUMBER: 376626282
VISIT DATE: 07/12/2022
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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 information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with the licensee [or facility representative] (include name).

A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra BlockTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022
LIC809 (FAS) - (06/04)
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