<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626534
Report Date: 11/28/2023
Date Signed: 11/28/2023 12:49:00 PM


Document Has Been Signed on 11/28/2023 12:49 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
SAN DIEGO N. CC RO, 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: 10DATE:
11/28/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:TIME COMPLETED:
01:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 11/28/23 at 12:10 PM, Licensing Program Analysts (LPAs) Annette Sutherland and Renita Rodriguez conducted a case management inspection because a deficiency was observed during a complaint inspection. Present in the home was licensee and helper Mirna Morales and 10-day care children.

LPA interviewed licensee and helper and reviewed documents. Both Licensee and helper have expired CPR cards. LPAs reviewed files and were found to be incomplete and infant files were missing infant safe sleep plans.

This deficiency is being cited per the California Code of Regulations, (Title 22, Division 6), and described on the attached LIC 809D.

A notice of site visit was given and must remain posted for 30 days. Licensee Rights (LIC 9098 01/16) along with a copy of this report was provided to Licensee Gredna Packer. Exit interview conducted and report was reviewed.
SUPERVISOR'S NAME: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2023
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 2


Document Has Been Signed on 11/28/2023 12:49 PM - 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
SAN DIEGO N. CC RO, 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: 11/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/28/2023
Section Cited
CCR
102416(c)

1
2
3
4
5
6
7
Personnel Requirements
102416(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:
1
2
3
4
5
6
7
Licensee stated that she has enrolled in CPR class and will email proof of certificate by 12/2823 to LPA Annette.Sutherland@dss.ca.gov.
8
9
10
11
12
13
14
Based on interview , the licensee did not comply with the section cited above both licensee and helper do not have current CPR cards which poses/posed a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Type B
12/01/2023
Section Cited
CCR102425(c)

1
2
3
4
5
6
7
Infant Safe Sleep
102425(c) An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee will have C1's parent fill out pending documents and submit proof to LPA by email Annette.Suthelrand@dss.ca.gov by 12/1/23.
8
9
10
11
12
13
14
Based on record review C1, does not have LIC 9227 in file. The licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
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: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 11/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2