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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610566
Report Date: 11/07/2024
Date Signed: 11/07/2024 02:21:54 PM

Document Has Been Signed on 11/07/2024 02:21 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:CAMPISTA, JOSEFA FAMILY CHILD CAREFACILITY NUMBER:
136610566
ADMINISTRATOR/
DIRECTOR:		JOSEFA CAMPISTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 677-1934
CITY:BRAWLEYSTATE: CAZIP CODE:
92227
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
11/07/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:07 PM
MET WITH:Josefa CampistaTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On November 7, @ 12:48 p.m. Licensing Program Analysts (LPAs) Angela Nguyen and Jacqueline Macias conducted an unannounced Required- 3 year Inspection and met with Licensee’s helper Leticia Orejel. Helper stated that licensee was picking up more kids and will be home soon. At 1:07 p.m. licensee arrived to the facility. LPA disclosed the purpose of the inspection and was granted facility entry by the Licensee. The Licensee, Licensee’s granddaughter, helper and 5 children were present in the facility during this inspection. 1 of those children is an infant. This facility is a 3 bedroom, 2-bathroom, single story house. Licensee accompanied LPA during this inspection.

The following areas used for childcare: living room, play room, Bedroom #2 bathroom #1 and backyard. The off-limit areas: bedroom #1 with included bathroom, bedroom #3 and kitchen. It is made inaccessible by the use of doorknob covers on the exteriors of the doors, safety gates and child proof latches. Licensee stated her hours of operation: Monday – Sunday from 5:00 a.m.- 10:00 p.m.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Home is clean, orderly and has adequate ventilation. The fire extinguisher, smoke detector, and carbon monoxide detector are operational. Hazardous items were observed in the off-limit area during this inspection. Children’s toys and play equipment are available and observed free of hazards. Licensee uses her fenced backyard for outdoor play. Licensee was reminded that continuous supervision is to be given to children whenever engaged in outdoor activities. There are no bodies of water or fireplaces observed in the home. Licensee stated there are no weapons or firearms in in the home.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2024
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: CAMPISTA, JOSEFA FAMILY CHILD CARE
FACILITY NUMBER: 136610566
VISIT DATE: 11/07/2024
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, Josefa Campista confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile.
To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

No deficiencies cited at this inspection.

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058) and notice of site visit (LIC 9213). Failure to comply with posting requirements shall result in an immediate civil penalty of $100. LPA provided notice of site visit and observed it being posted at the facility.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
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: CAMPISTA, JOSEFA FAMILY CHILD CARE
FACILITY NUMBER: 136610566
VISIT DATE: 11/07/2024
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Licensee’s First Aid and CPR certifications expire 08/2025. Licensee has required immunizations. Mandated Reporter Training expires in 7/13/2025. LPA reminded licensee that Mandated reporter and Pediatric CPR/ First aid expires every 2 years and shall be kept on file at the facility. The facility roster is maintained and was reviewed. Fire and earthquake drills were conducted and documented every month this year. Child record review was conducted and determined to be complete.

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.

LPA discussed the safe sleep regulations with licensee 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 licensee 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.

Incidental Medical Services (IMS) policy was reviewed with licensee however, are not being provided at this time. Licensee stated that she will inform LPA when there are children enrolled and submit a plan to Licensing office. LPA advised licensee to inform LPA to create a plan to submit to the department. For IMS information see PIN 22-02-CCP. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC809 (FAS) - (06/04)
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