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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701058
Report Date: 05/23/2019
Date Signed: 05/23/2019 06:20:53 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:KIDDIES KORNERFACILITY NUMBER:
376701058
ADMINISTRATOR:SANYA KERNEYFACILITY TYPE:
830
ADDRESS:12334 OAK KNOLL ROADTELEPHONE:
(858) 486-1775
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:15CENSUS: 11DATE:
05/23/2019
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
03:46 PM
MET WITH:Sandy Kerney TIME COMPLETED:
06:30 PM
NARRATIVE
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Licensing Program Analyst Vicky Williamson conducted an annual/required inspection. Met with Lead Teacher Dallas Camerlinck. The facility operates Monday-Friday from 6:30 am to 5:30 pm. Director Sanya Kerney arrived during the inspection.

The indoor and outdoor of the facility was inspected. Infant classroom had 11 infants (5 months – 1 year). The infants were observed eating snack and under visual supervision. LPA was advised by Staff #1 and Staff #2 that Staff #3 was on a lunch break. The infant classroom operated out of ratio for approximately 20 minutes before Staff #3 returned. LPA observed 3 prohibited items (2 baby exersaucers and 1 baby jumper) in the infant classroom. There were no infants utilizing the prohibited items during time of inspection. The facility has indoor and outdoor activity space for infants physically separate from space used by the preschool. The classroom and restroom have adequate lighting, heating, and ventilation. All floors appeared to be clean and safe. Furniture, children's cubbies, toys and napping equipment (cribs) appeared to be in good condition. Infant changing table is within arm's reach of a sink. Disinfectants, cleaning solutions and other hazardous items are stored behind latched cabinets and inaccessible to children. Trash cans containing discarded food have tight-fitting covers. Children bring their own lunch and snack. Facility also has additional snacks available. Food and formulas for infants are labeled with names and dates. The kitchen and storage areas appeared to be clean. All food was inspected and protected from contamination. The surface of the outdoor activity space is maintained in a safe condition, free of hazards and sufficient shade. Drinking water is available inside the classrooms and outdoor play area. Sign in/out sheets were reviewed showing parent/guardian’s signature and time of day recorded. A sample of the children's records, including medical assessment and identification & emergency information were all reviewed. Infant needs & services plan including individual feeding plan for each infant were reviewed and are being updated every 3 months. Staff's records and transcripts were reviewed to verify teacher qualifications and experiences. Opening and closing staff members have current CPR and First Aid certifications. There are no firearms/weapons or bodies of water present on the premises. Immunization records were not available for review for Staff #4 during time of inspection. The last fire drill was conducted and documented on 3/18/19. The director's office is designated for use by children who are ill.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2019
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: KIDDIES KORNER
FACILITY NUMBER: 376701058
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/23/2019
Section Cited

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Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center 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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The requirement is not met as evidence by: Immunization records for Staff #4 were not available for review during time of inspection. This poses a potential health and 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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:
DATE: 05/23/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2019
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: KIDDIES KORNER
FACILITY NUMBER: 376701058
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2019
Section Cited

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Personal Rights The licensee shall ensure that each child is accorded the following personal rights:To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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The requirement was not met as evidence by: LPA observed 2 exersaucers and 1 jumper in the infant classroom that were not in use.It was determined that these are prohibited items. This poses a potential health and safety risk to children in care.
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Type B
05/30/2019
Section Cited

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Staff-Infant Ratio There shall be a ratio of one teacher for every four infants in attendance. An aide may be substituted for a teacher when all of the following conditions are met:Each aide is responsible for the direct care and supervision of a group of no more than four infants.

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The requirement is not met as evidence by: 11 infants in the infant classroom with 1 teacher and 1 aide. Staff #3 returned to the classroom in approx. 20 minutes after LPA's arrival. This poses a potential health and 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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:
DATE: 05/23/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/23/2019
LIC809 (FAS) - (06/04)
Page: 3 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: KIDDIES KORNER
FACILITY NUMBER: 376701058
VISIT DATE: 05/23/2019
NARRATIVE
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A review of staff records on 3/18/19 indicated that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

LPA reviewed the following with Licensee: SIDS, Shaken Baby Syndrome, reporting requirements, New Safe Sleep Regulation Concepts (pamphlet), and Effects of Lead Exposure (pamphlet). Director was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care.



New immunization law (SB792) was discussed with Director. Director understands that anyone who provides care and supervision to the children must have immunization records maintained at the facility for: pertussis, measles, and influenza.

LPA and Licensee discussed California Megan's Law and LPA provided:www.meganslaw.ca.gov.

Facility was provided a copy of the appeal rights form LIC 9058 and the signature on this form acknowledges receipt of these rights.

Please update and submit form LIC 308 and LIC 610, to the Licensing Agency by June 23, 2019.

See LIC 809 for deficiencies cited.

The Notice of Site Visit (LIC 9213) was provided to be posted at the facility for 30 days. LPA observed form LIC 9213 posted. An exit interview was conducted.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4