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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626534
Report Date: 10/10/2019
Date Signed: 10/10/2019 04:23:20 PM

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:PACKER,GREDNA FAMILY CHILD CAREFACILITY NUMBER:
376626534
ADMINISTRATOR:GREDNA PACKERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 229-2035
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY:14CENSUS: 8DATE:
10/10/2019
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Gredna PackerTIME COMPLETED:
03:45 PM
NARRATIVE
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(3) Licensing Program Analysts (LPAs) Selina Siao and Tyra Block conducted an unannounced 3 years inspection. Upon arrival, helper Patricia Escamilla was at the facility with 8 children that were napping in a playpens or napping mats. Facility is out of ratio as there were six infants and two preschool children in care. Licensee returned to the facility at 2:10pm. The home was toured and inspected to ensure an environment safe for the care and supervision of children. The home has a fully charged fire extinguisher size 3A40BC, smoke and carbon monoxide detector that meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Licensee stated that the home does not have any bodies of water or weapons. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances. Licensee’s First Aid and CPR certifications are current due to expire on 07/2021 and her helper also has a valid EMSA approved pediatric CPR and First Aid card. Children’s records and facility roster were reviewed. Licensee last conducted a drill with the children in care on 08/08/2019.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include living room, family room, dining area, kitchen, bedroom 2 for napping and bathroom 1. Off limits areas include bedroom 1, master bedroom/bath and attached garage. All off limit areas are inaccessible through use of safety door device. Facility has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 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: PACKER,GREDNA FAMILY CHILD CARE
FACILITY NUMBER: 376626534
VISIT DATE: 10/10/2019
NARRATIVE
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Per new Senate Bill 792 pertaining to immunizations, which require all adults in daycare operation to have proof of immunizations for; Measles, Pertussis and Influenza is optional. Licensee has the required immunizations but her helper's immunization recrods and TB record is not available for review.

The following items were discussed with provider: Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. Licensee was provided with information about Heat Related Illness, Sudden Infant Death Syndrome (SIDS), Never Shake a Baby, safe sleep for infants, best practice on supervision, latest car seat poster and effects of lead exposure and reporting responsibilities were discussed. Fall 2019 Quarterly updates was provided to licensee and the information is available at www.ccld.ca.gov. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

The following handouts were provided to the licensee today:
  • PIN 19-10-CCP – U.S. Consumer Product Safety Commission recall
  • PIN 19-09-CCP – Head Lice Information for Child Care Providers
  • Health & Human Services Agency Guidance on Head Lice Prevention and Control
  • PIN 19-08-CCP – CA Department of Public Health New Pre-Kindergarten Immunization requirements
  • PIN 19-06-CCP – U.S. Consumer Product Safety Commission recall
  • PIN 19-02-CCP – Safe Sleep Awareness Campaign


See LIC809D for deficiencies:

"Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. “

A Notice of Site Visit was posted today and it must remain posted for a period or 30 days. Failure to keep notice posted will result in a civil penalty of $100.00. Provided appeal rights to licensee today.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
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: PACKER,GREDNA FAMILY CHILD CARE
FACILITY NUMBER: 376626534
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/31/2019
Section Cited

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Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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This requirement was not met as evidenced by: Helper Patricia Escamilla's immunization records are not available for review. This poses a potential health and safety risk to clients in care.
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no later than 10/31/2019.
Type B
10/31/2019
Section Cited

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Evidence of a current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home, for any adult in the home during the time that children are under care.
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This requirement was not met as evidenced by: Helper Patricia Escamilla's TB record is not available for review. This poses a potential health and safety risk to clients in care.
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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: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2019
LIC809 (FAS) - (06/04)
Page: 4 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:
FACILITY NUMBER:
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/10/2019
Section Cited

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For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:(1) Twelve children, no more than four of whom may be infants.
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This requirement was not met as evidenced by:Upon arrival, helper Patricia Escamilla was alone supervising 8 children including 6 infants and 2 preschool age children. Licensee returned 25 minutes later and the facility is still out of ratio by having more than 4 infants. This poses an immediate health and safety risk to clients in care.
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submit a written plan of correctiion to Licensing.

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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: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4