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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844405
Report Date: 08/17/2022
Date Signed: 08/17/2022 02:01:06 PM

Document Has Been Signed on 08/17/2022 02:01 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:BRUCE FAMILY CHILD CAREFACILITY NUMBER:
334844405
ADMINISTRATOR:BRUCE, KIMAHNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 821-1193
CITY:MURRIETASTATE: CAZIP CODE:
92563
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
08/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Licensee Kimahna BruceTIME COMPLETED:
02:10 PM
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On 08/17/2022 at 9:00 AM Licensing Program Analyst (LPA) Susan Brewer, arrived at the facility to conduct an annual inspection. LPA was greeted by Licensee Kimahna Bruce, conducted a COVID-19 pre-screening and granted entry to tour the facility, inside and out. LPA reviewed records and observed and/or discussed the following: Present were the licensee, the licensee’s spouse, 1 adult resident and 1 minor resident. The licensee will provide updated LIC279 application form, LIC610A relocation sites. LIC999A facility sketches.

Normal days and hours of operation are Monday- Friday, 7:30 AM to 5:30 PM
OFF-LIMIT AREAS INCLUDE: 1st Floor Living Room, Dining Room, Kitchen, Bedrooms, closets, laundry room, Entire 2nd Floor, and both side yards.

The inspection consisted of reviews of the following domain: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio and Capacity, Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D.
· The facility is operating within the licensed capacity and appropriate ratios. LPA took a census of 8 children in the care of the license and assistant, where 3 of the 8 children in care are infants.
· The Licensee is present in the home and has ensured that children in care are supervised.
· When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children, working on a new hire.
· A working telephone is present by landline and cell phone.
· Appropriate fire extinguisher tagged by fire dept. on 11/03/2021, smoke detector present and At 9:37 AM the smoke alarms were tested by the Licensee during this inspection. Per licensee the smoke alarms were just replaced in July 2022, and she mistakenly purchased the wrong devices, and thought that the devices were combination smoke and carbon monoxide alarms. Carbon monoxide detector is NOT present on 08/17/2022.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2022
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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: BRUCE FAMILY CHILD CARE
FACILITY NUMBER: 334844405
VISIT DATE: 08/17/2022
NARRATIVE
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· All hazardous items are inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children.
· Storage of poisons is inaccessible to children and locked
· There is a properly barricaded fireplace on 08/17/2022.
· No guns or weapons present as stated by the Licensee Kimahna. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations.
· Stairs are barricaded on 08/17/2017.
· Home is clean and orderly, with heating and ventilation for safety and comfort.
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced and/or appropriate supervision is present on 08/17/2022.
· Verification of control of property on file verified by rental agreement on 02/01/2017.
· Property owner/landlord notification and consent on file 12/12/2017.
· Pediatric CPR and First Aid Card expired: 03/25/2021 and NOT renewed.
· Health, Safety Nutrition Certificate - completed on 03/26/2017, no lead.
· Mandated reporter General: NOT on file; AB1207 Child Care Expired 02/2021, NOT renewed.
· Fire clearance: 05/13/2019
· Documentation of fire & earthquake drills to be conducted every six months: Last drill 08/17/2022 at 10:15 AM, during inspection with 8 children present and 1 assistant, lasted 15 minutes.
· There are no bodies of water, at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Children’s files are NOT complete and identified on confidential names list.
1. Child 1: Missing LIC995A Parents Rights, Sleep Logs, enrolled 06/21/2021
2. Child 3: Missing LIC995A Parent Rights, Immunizations, Sleep Logs, enrolled 08/08/2022.
3. Child 4: Missing Immunizations, enrolled 08/08/2022.
4. Child 5: Missing LIC282, LIC995A Parents Rights, Immunizations, Sleep logs
5. Child 6: Missing LIC995A Parents Rights
6. Child 7: Missing LIC995A Parents Rights
7. Child 8: Missing and Infant Sleep Logs
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
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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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: BRUCE FAMILY CHILD CARE
FACILITY NUMBER: 334844405
VISIT DATE: 08/17/2022
NARRATIVE
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· Staff 1 files are complete. The licensee Kimahna Bruce, has 1 minor resident assisting with the large capacity, who meets the Title 22 requirements for age criteria.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee Kimahna Bruce, was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA Susan Brewer, discussed the safe sleep regulations with licensee Kimahna Bruce 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 re-called 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.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: BRUCE FAMILY CHILD CARE
FACILITY NUMBER: 334844405
VISIT DATE: 08/17/2022
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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.

Deficiencies cited this visit, See LIC809D for 6 Type B citations.

No civil penalties issued on 08/17/2022.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Kimahna Bruce.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/17/2022 02:01 PM - It Cannot Be Edited


Created By: Susan Brewer On 08/17/2022 at 12:22 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BRUCE FAMILY CHILD CARE
FACILITY NUMBER: 334844405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on Susan Brewer, record review, the licensee Kimahna Bruce did not comply with the section cited above in a requiremen to have a Carbon monoxide detector, was NOT present on 08/17/2022, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/18/2022
Plan of Correction
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The licensee Kihmahna Bruce, stated that a carbon monoxide device will be purchased, installed at the facility and proof will be sent by photos and/or videos to the department on or before 08/18/2022. The licensee agrees to write a statement of understanding the responsibility to comply with the section cited above to meet the Health and Safety Standards.
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee Kimahna Bruce, did not comply with the section cited above in LPA Susan Brewer reviewed records on 08/17/2022 for daycare children identified as 3, 4 and 5 on the confidential names list and were missing proof of immunization records, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/22/2022
Plan of Correction
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The licensee Kimahna Bruce, stated that immunization records will be obtained for daycare children identified as 3, 4 and 5 on the confidential names list, and proof of documentation will be submitted to the department along with a statement of understanding the cited Title 22 regulation 102418(g), by mail, fax or e-mail, on or before 08/22/2022.
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:Pauline Beschorner
LICENSING EVALUATOR NAME:Susan Brewer
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/17/2022 02:01 PM - It Cannot Be Edited


Created By: Susan Brewer On 08/17/2022 at 12:22 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BRUCE FAMILY CHILD CARE
FACILITY NUMBER: 334844405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Susan Brewer's record review for daycare children on 08/17/2022, the licensee Kimahna Bruce, did not comply with the section cited above in the licensee was unable to provide proof the LIC995A Parents' Rights form signature receipts for daycare children identified as 1, 3, 5, 6 and 7 on the confidential names list which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/22/2022
Plan of Correction
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The licensee Kimahna Bruce, stated that the LIC995A Parents Rights forms will be obtained for daycare children identified as 1, 3, 5, 6 and 7 on the confidential names list and agrees to submit proof of the required documentation to the department with a statement of understanding the regulation cited for Title 22 102419(d)(1), on or before 08/22/2022.

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:Pauline Beschorner
LICENSING EVALUATOR NAME:Susan Brewer
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022


LIC809 (FAS) - (06/04)
Page: 6 of 10
Document Has Been Signed on 08/17/2022 02:01 PM - It Cannot Be Edited


Created By: Susan Brewer On 08/17/2022 at 12:22 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BRUCE FAMILY CHILD CARE
FACILITY NUMBER: 334844405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on LPA Susan Brewer's record review on 08/17/2022, the licensee Kimahna Bruce, did not comply with the section cited above in the licensee failed to maintain infant safe sleep logs for infant daycare children identified as Child 1 - DOB: 12/29/2020, Child 3 - DOB: 07/13/2021 and Child 8 - DOB: 01/06/2021 on the confidential names list. which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/18/2022
Plan of Correction
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The licensee Kimahna Bruce, agrees to provide proof of documentation for infant safe sleep and maintain sleep logs for children identified as infants through the age criteria in Title 22 regulation 102425, and agrees to submit proof of documentation on or before 08/18/2022.
Type B
Section Cited
HSC
1596.8662(b)(1)

H&S Section 1596.8662(b)(1) AB 1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning January 1, 2018 – Requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Susan Brewer, record review 08/17/2022, the licensee Kimahna Bruce, did not comply with the section cited above, by failing to renew the Mandated Child Abuse Training for Child Care Providers, where the certificate for AB1207 expired on 02/2021, Part 1 General exam not completed, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/31/2022
Plan of Correction
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The licensee Kimahna Bruce, agrees to provide the Mandated Reporter Training completed for Part 1 General and Part 2 AB1207 Child Care Providers, and submit proof of participation on or before 08/31/2022.
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:Pauline Beschorner
LICENSING EVALUATOR NAME:Susan Brewer
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/17/2022 02:01 PM - It Cannot Be Edited


Created By: Susan Brewer On 08/17/2022 at 01:12 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: BRUCE FAMILY CHILD CARE
FACILITY NUMBER: 334844405

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)

The licensee and other personnel as specified shall complete the Preventative Health and Safety training including pediatric cardiopulmonary resuscitation and pediatric first aid, persuant to Health and Safety Code 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA Susan Brewer, record review, the licensee Kimahna Bruce, did not comply with the section cited above in the licensee failed to renew the CPR/1st Aid Training, which expired on 01/2021, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/31/2022
Plan of Correction
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2
3
4
The licensee Kimahna Bruce, agrees to submit proof of registration to renew the CPR and 1st Aid training, along with a written statement of understaing the regulation 102416(c), to the department on or before 08/31/2022, by fax, mail or e-mail.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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2
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4
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:Pauline Beschorner
LICENSING EVALUATOR NAME:Susan Brewer
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022


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