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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701058
Report Date: 01/04/2023
Date Signed: 01/04/2023 01:53:30 PM


Document Has Been Signed on 01/04/2023 01:53 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:KIDDIES KORNERFACILITY NUMBER:
376701058
ADMINISTRATOR:SANYA KERNEYFACILITY TYPE:
830
ADDRESS:12334 OAK KNOLL ROADTELEPHONE:
(858) 486-1775
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:15CENSUS: 13DATE:
01/04/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:16 PM
MET WITH:Sanya Kerney TIME COMPLETED:
02:15 PM
NARRATIVE
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On 1/4/23 at 8:30 AM Licensing Program Analyst Annette Sutherland (LPA) and Licensing Program Manager (LPM) Monica Cuddy conducted case management inspection . During a tour of the classroom, the following was observed:

An infant was sleeping in the crib with a blanket, staff removed blanket during visit. A second infant was observed being swaddled, director freed up the infants arms. There was a mobile on an empty crib. Director did not have sleep logs for infants. Adult scissors were accessible to children, staff removed them during visit. The vinyl on the changing pad was torn, Director ordered new changing pads during visit. There is no sink within arms reach of changing table. Diaper pail did not have a lid. Infant bottles did not have dates on them. Staff personal belongings were accessible to children. There is no cushioning below the indoor climbing wall.

See LIC 809D for Type A & B deficiency.

LPA Annette Sutherland and LPM Monica Cuddy informed facility representative Sanya Kerney that this report dated 1/4/23 documents 2 Type A citation(s) which shall be posted for 30 consecutive days as there is an immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Annette Sutherland informed the facility representative Sanya Kerney to provide a copy of this licensing report dated 1/4/23 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
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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Document Has Been Signed on 01/04/2023 01:53 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
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: 01/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/04/2023
Section Cited

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101430 (A)(3)(C) Infant Care Activities. An infant shall not be swaddled while in care. This requirment was not met as evidenced by
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Director freed childs arm during visit. Director states that she understands that infants are not to be swaddled.
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Based on LPA observation. An infant was swaddled. This poses an immediate risk to the health and safety of children in care.
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Type A
01/04/2023
Section Cited

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101439.1 Infant Care Center Sleeping Equipment. Cribs shall be free from all loose articles and objects, including blankets and pillows. This requirment was not met as evidenced by
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Staff removed blanket during visit. Director states that she now understands that blankets are not allowed to be in the crib.
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Based on LPA observation . An infant was sleeping with a blanket. This poses an immediate risk to the health and safety of 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/04/2023 01:53 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
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: 01/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/11/2023
Section Cited

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101439 Infant Care Center Fixtures, Furniture, Equipment and Supplies. Infant changing tables shall: Be maintained in good repair and safe condition. This requirement was not met as evidenced by
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Director ordered new changing pads during visit. Director will provide photo of new changing pad on changing table by 1/11/23.
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Based on LPA observation diaper changing pad was torn and foam was exposed. This poses a potential risk to the health and safety of children in care.
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Type B
01/04/2023
Section Cited

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101439 Infant Care Center Fixtures, Furniture, Equipment and Supplies. Infant changing tables shall:While in use, be placed within arm's reach of a sink. This requirement was not met as evidenced by
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Director states that she will have a changing table made to fit in the bathroom close to the sink Director will provide photo of new changing table by 02/6/23.
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Based on LPA observation sink is not within arms reach of the changing table. This poses a potential risk to the health and safety of 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6


Document Has Been Signed on 01/04/2023 01:53 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
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: 01/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/11/2023
Section Cited

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101239 Fixtures, Furniture, Equipment and Supplies. Solid waste shall be stored, located and disposed of in a manner that will not transmit communicable diseases or odors, create a nuisance, or provide a breeding place or food source for insects or rodents. (1) All containers used for storage of solid wastes, including moveable bins, shall have a tightfitting cover that is kept on; shall be in good repair; and shall be leakproof and rodent-proof. This requirement was not met as evidenced by
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Director states she will replace diaper genie with one that has a lid and understands it must be closed.
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 Based on LPA observation diaper pail did not have a lid. This poses a potential risk to the health and safety of children in care.
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Type B
01/05/2023
Section Cited

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101427 Infant Care Food Service. Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date. This requirment was not met as evidenced by
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Director states she will date bottles.
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Based on LPA observation bottles did not have dates. This poses a potential risk to the health and safety of 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6


Document Has Been Signed on 01/04/2023 01:53 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
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: 01/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/04/2023
Section Cited

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101238.2 Outdoor Activity Space. As a condition of licensure, the areas around and under high climbing equipment, swings, slides and other similar equipment shall be cushioned with material that absorbs falls. This requirement was not met as evidenced by
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Director states she will remove upper rows so that it is not climbable.
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Based on LPA observation climbing wall in infant room did not have cushioned material underneath. This poses a potential risk to the health and safety of children in care.
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Type B
01/04/2023
Section Cited

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101238 Buildings and Grounds . Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirmetn was not met as evidenced by
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Staff removed adult scissors and Director will have staff to use a higher shelf.
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Based on LPA observation adult scissors and staff personal belongings were accessible to infants in care. This poses a potential risk to the health and safety of 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6


Document Has Been Signed on 01/04/2023 01:53 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
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: 01/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/04/2023
Section Cited

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101429 Responsibility for Providing Care and Supervision for Infants. Sleeping infant(s) shall be directly observed by sight and sound at all times. Documentation shall be maintained in the infant’s file and be available to the Department for review. This requirement was not met as evidenced by
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Director stated she will log and send LPA proof by 1/5/23.
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Director stated that she was not aware she needed to maintain a sleep log. This poses a potential risk to the health and safety of children in care.
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Type B
01/04/2023
Section Cited

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101439.1 Infant Care Center Sleeping Equipment. There shall be no objects hanging above or attached to the side of the crib. This requirement was not met as evidenced by
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Director stated she will remove mobile from crib.
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Based on LPA observation there was a mobile attached to a crib. This poses a potential risk to the health and safety of 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 01/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/04/2023
LIC809 (FAS) - (06/04)
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