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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628181
Report Date: 10/02/2023
Date Signed: 10/02/2023 02:24:38 PM


Document Has Been Signed on 10/02/2023 02:24 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:FELDER, CLAUDIA FAMILY CHILD CAREFACILITY NUMBER:
376628181
ADMINISTRATOR:CLAUDIA FELDERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 917-1731
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY:14CENSUS: 10DATE:
10/02/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Claudia Felder TIME COMPLETED:
02:25 PM
NARRATIVE
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On 10/2/23 at 1:15 PM LPA Annette Sutherland was conducting an inspection concerning another matter at the facility. LPA toured facility and met licensee Claudia Felder. Also in the home was adult son Kevin Chapa Ramirez and staff #1 that is fingerprint cleared but is not associated to facility. There are 10 day care children present.

Type B deficiency cited on LIC 809D and Civil penalty assessed.

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 Licensees Claudia Felder. Exit interview conducted and report was reviewed with the licensee Claudia Felder.
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2230
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2023
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 10/02/2023 02:24 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: FELDER, CLAUDIA FAMILY CHILD CARE
FACILITY NUMBER: 376628181

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/02/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/03/2023
Section Cited
CCR
102370(d)(2)

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102370 Criminal Record Clearance (d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (2)Request a transfer of a criminal record clearance as specified in Section 102370(j) This requirement was not met as evidenced by:
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Deficiency has been cleared. LPA has associated Staff #1 to facility as licensee stated she was having issues with guardian. Staff #1 has worked at facility since July. Licensee understands that any adult living or working at facility must be finger print cleared and associated. Licensee understands that if having issues with guardian she must contact office to associate adults.
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Licensee did not associate staff #1 to facility which poses a potential health & safety risk to children 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: Renesha AskewTELEPHONE: (619) 767-2230
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2