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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629006
Report Date: 09/23/2024
Date Signed: 09/23/2024 03:06:55 PM

Document Has Been Signed on 09/23/2024 03:06 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:GOLDSBERRY, LEEZLY FAMILY CHILD CAREFACILITY NUMBER:
376629006
ADMINISTRATOR/
DIRECTOR:		LEEZLY GOLDSBERRYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 451-6689
CITY:SAN YSIDROSTATE: CAZIP CODE:
92173
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
09/23/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Leezly GoldsberryTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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On 09/23/2024 at 1:00 PM, Licensing Program Analyst's (LPA's), Julieta Abrego and Michelle Hood conducted an unannounced Annual Required Inspection and met with Licensee Leezly Goldsberry. LPA's disclosed the purpose of the inspection and were granted entry into the facility by the Licensee. There was 1 daycare child and the licensee's 2 minor children with 2 staff present in the facility during this inspection. The licensee accompanied LPA inside and out of the facility during this inspection. The off-limits areas are inaccessible using door locks. Per the licensee the operating hours are 24 hours a day 7 days a week. Licensee stated she cares for children ages 2 and older. The following areas are used for daycare purposes: entire first floor. The off-limits areas are inaccessible through the use of door knob covers, baby gates and door locks. The second floor is off limits and properly barricaded at the base of the staircase with a baby gate.

The fire extinguisher, smoke detector, and carbon monoxide detector met the requirements. All hazardous items were inaccessible to children. The licensee has toys, play equipment, and materials available. The backyard is used for outdoor activities and is properly fenced. No bodies of water were observed on the premises during the inspection. The licensee stated there are no weapons or firearms in the facility. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Licensee’s First Aid and CPR certifications expire on 02/2026. The licensee has required immunizations. Licensee completed Mandated Reporter Training. The facility roster is maintained and reviewed. LPA reviewed children’s files. The last fire and disaster drills were conducted and documented on 09/23/24.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Julieta Abrego
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2024
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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GOLDSBERRY, LEEZLY FAMILY CHILD CARE
FACILITY NUMBER: 376629006
VISIT DATE: 09/23/2024
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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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA discussed the following: Reporting Covid positive, suspected child abuse & neglect, maintaining children’s records according to regulation, and post required forms. The licensee was reminded corporal punishment, smoking, exersaucers, bouncy seats, walkers, jumpers, and/or similar equipment are not allowed in daycare. During the exit interview, the licensee Leezly Goldsberg, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. LPA provided the California Megan's Law website: www.meganslaw.ca.gov.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. 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. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

An exit interview was conducted, and the report was reviewed with the licensee Leezly Goldsberry. The licensee was provided with a copy of their appeal rights (LIC 9058 03/22) and their signature on this form acknowledges receipt of these rights. A 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. No deficiencies were cited.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Julieta Abrego
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2024
LIC809 (FAS) - (06/04)
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