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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700682
Report Date: 01/12/2023
Date Signed: 01/12/2023 05:33:26 PM

Document Has Been Signed on 01/12/2023 05:33 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:KID'S BAY - INFANT, THEFACILITY NUMBER:
376700682
ADMINISTRATOR:SHEREE NICHOLSFACILITY TYPE:
830
ADDRESS:13770 CARMEL VALLEY ROADTELEPHONE:
(858) 240-6710
CITY:SAN DIEGOSTATE: CAZIP CODE:
92130
CAPACITY: 36TOTAL ENROLLED CHILDREN: 29CENSUS: 26DATE:
01/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Sheree Nichols & Jacqueline Sandoval-RoweTIME COMPLETED:
03:00 PM
NARRATIVE
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On 1/12/23 @ 12:20PM, LPA Nancy Diaz conducted an unannounced inspection. LPA disclosed the purpose of the inspection and was granted facility entry by site director. LPA toured the facility with Jacqueline Sandoval-Rowe. Observed present today were 26 infants & toddlers. There are 2 classrooms designated for infants & toddlers. Some of the children observed today were napping - Turtle room with 8 infants and staff Susan Woolf & Elizabeth Grubbiss. Stingray Room with 18 toddlers and staff Kaiya Goodman-Fenter; Melika Yarmohammadi. Staff Alexa Redzio & Haidde Perez returned from their breaks and went into the Stingray room shortly after the tour. Paula Alimohamadi was on break during the tour.

A review of staff records on this date indicates that some of the staff who require caregiver background checks were not associated to the facility. The licensee has not exceeded the conditions, limitations and capacity specified on the license. Site director, Assistant Director and several staff trained trained in CPR and Pediatric First aid were present today.

Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Medications are kept in a safe place, inaccessible to children. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All toilets, handwashing facilities are in safe and sanitary operating condition. All floors are clean and safe. The child care center was observed to be clean, safe, sanitary and in good repair to ensure the safety and well-being of children, employees and visitors. Facility maintains a carbon monoxide detector that meet the standards established in Chapter 8 of Part 2 of Division 12.

The kitchen, food-preparation and storage areas are kept clean, free of litter. Food are protected against contamination. All storage containers for solid waste have a tight-fitting covers that are kept on and in good repair.
Tashima Daniel
Nancy Diaz
DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: KID'S BAY - INFANT, THE
FACILITY NUMBER: 376700682
VISIT DATE: 01/12/2023
NARRATIVE
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Playground equipment was observed to be in safe condition, free of sharp, loose or pointed parts. Several holes were observed in the toddler play area that poses tripping hazzard.

Children were observed to be under the supervision of qualified staff. Facility was observed to be within ratio. An isolation area has been designated for children who becomes ill during the day.

Children’s records were reviewed today. All required forms were on file. Menus are posted in a place visible by the child’s authorized representative. All children are signed in/out by a representative who uses a full legal signature and has recorded the time of day. Child’s record also contain a medical assessment.

Staff records reviewed today contain a health screening as required by the regulation.
Staff have completed the mandated reporter training (effective 3/2018). This training shall be renewed every two years. All staff have immunization record indicating that they have been immunized against influenza, pertussis and measles.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Site Director was reminded that all adults 18 and over, 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 Child Care Center. 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.
SUPERVISOR'S NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
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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: KID'S BAY - INFANT, THE
FACILITY NUMBER: 376700682
VISIT DATE: 01/12/2023
NARRATIVE
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LPA discussed the safe sleep regulations with Site director 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 site director 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.

LPA provided site director information regarding the new safe sleep regulation. During file review, it was discovered that staff did not maintain current sleep logs for all infants in care. Sleep logs are to be maintained for children 0-24 months.

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/process.

TYPE A AND B DEFICIENCIES WERE CITED.

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.

Exit interview conducted and report was reviewed with facility representative, Sheree Nichols. A copy of this report, along with Appeal Rights (LIC9058), were provided. A notice of site visit was provided and observed posted. This notice shall remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
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Document Has Been Signed on 01/12/2023 05:33 PM - It Cannot Be Edited


Created By: Nancy Diaz On 01/12/2023 at 04:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KID'S BAY - INFANT, THE
FACILITY NUMBER: 376700682

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Request Denied
Type A
Section Cited
CCR
101170(e)(2)
Criminal Record Clearance
(e) 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 101170(f) or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. Two staff fingerprint clearances were not associated to the faciltiy. Staff Paula Alimohamadi (employed in 11/13/2015) and Melika Yarmohammadi (employed in 10/3/22). Not associating fingerprint clearance to the facility poses an immediate risk to the health, safety or personal rights of children in care.
POC Due Date: 01/12/2023
Plan of Correction
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CORRECTED TODAY. Mrs. Nichols fax'd forms LIC 9182 for staff Paula Alimohamadi & Melika Yarmohammadi today.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Tashima Daniel
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023


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Document Has Been Signed on 01/12/2023 05:33 PM - It Cannot Be Edited


Created By: Nancy Diaz On 01/12/2023 at 04:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KID'S BAY - INFANT, THE
FACILITY NUMBER: 376700682

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(d)(2)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. LPA observed toddler's play area with holes that poses tripping hazzards. Holes in the toddler play area poses a potential risk to children at play.
POC Due Date: 01/23/2023
Plan of Correction
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Ms. Nichols stated that she will obtain a work order and submit to the department the plan stating the duration of repair no later than 1/23/2023.
Type B
Section Cited
CCR
101429(a)(2)(B)
Responsibility for Providing Care and Supervision for Infants
(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. Staff failed to maintain nap logs for all infants and toddlers in care. Not maintaining nap logs poses a potential risk to the health, safety or personal rights of children in care.
POC Due Date: 01/19/2023
Plan of Correction
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Ms. Nichols will train her infant/toddler staff regarding maintaining the nap log and ensure that all teacher will be required to maintain nap logs beginning 1/13/2023. Ms. Nichols will submit sample nap logs to the department no later than end of business of 1/19/2023.
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:Tashima Daniel
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/12/2023 05:33 PM - It Cannot Be Edited


Created By: Nancy Diaz On 01/12/2023 at 04:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KID'S BAY - INFANT, THE
FACILITY NUMBER: 376700682

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101415.1(b)(1)
Assistant Infant Care Center Director Qualifications and Duties
(b) The assistant infant care center director shall meet the following qualifications: (1) Be a fully qualified infant care teacher.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review)], the licensee did not comply with the section cited above. Ass't director Jacqueline Sandoval-Rowe is not a fully qualified infant care teacher. Ms. Sandoval-Rowe is missing units in infant/toddler. Ms. Sandoval-Rowe has a current Site Supervisor Permit that is valid thru May 1, 2024. Staff not being a fully qualified infant teacher poses a potential risk to the health, safety or personal rights risk to persons in care.
POC Due Date: 01/19/2023
Plan of Correction
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Ms. Sandoval-Rowe stated that she will register to complete the infant toddler class in the Spring Semester. In the meantime, Ms. Nichols designated a fully qualified infant teacher as the assistant director until Ms. Sandoval-Rowe completes her infant toddler units. Interim ass't director is Mojan Martin. Documents were received today.
Section Cited
Assistant Infant Care Center Director Qualifications and Duties
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Tashima Daniel
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023


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