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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372010482
Report Date: 03/03/2023
Date Signed: 03/03/2023 09:48:40 AM

Document Has Been Signed on 03/03/2023 09:48 AM - 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:CARPENTER, VIVIAN FAMILY CHILD CAREFACILITY NUMBER:
372010482
ADMINISTRATOR:VIVIAN CARPENTERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 560-6433
CITY:SAN DIEGOSTATE: CAZIP CODE:
92124
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 2DATE:
03/03/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Vivian CarpenterTIME COMPLETED:
09:55 AM
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On 3/3/23 at 8:35 AM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced Proof of Corrections (POC) visit to facility. Upon arrival, LPA met with Licensee Vivian Carpenter and toured the facility. Also present were assistant Electra Carpenter, Scott Harris and two daycare children. Proper supervision, ratios and capacity were observed. At previous annual inspection dated 1/20/23, LPA Lane cited deficiencies for following items: mandated reporter training not being completed by Licensee and staff, children’s records were incomplete and areas of the home had visible clutter that was covering kitchen counters. On 2/20/23 and 2/22/23, LPA received photos via e-mail of corrections in the home, mandated reporter certificates for Licensee and staff as well as completed children’s records. Although the Licensee had sent pictures showing areas cleaned up, at the visit, LPA observed kitchen and surrounding areas still cluttered.

Licensee stated it rained on Wednesday again and they had to bring items back in and they are still in the process of purging excess items. Licensee also stated they haven’t been able to fix the ceiling damage yet as it hasn’t been dry enough from the excessive rain. LPA requested to update her on the ceiling situation once fixed. LPA Lane stated she would provide proof of corrections for the mandated reporter training completed and children’s records corrected by mail, however LPA will cite for the kitchen area again.

At 8:52 AM, Licensee stated she had to leave for an appointment and Electra Carpenter was staying with the children. Another child arrived at 9:00 AM for a total of three children in care. Pursuant to Title 22 of the CA Code of Regulations, the following Type B deficiency was cited (refer to LIC 809-D). Exit interview conducted and report was reviewed with facility representative Electra Carpenter. Notice of site visit was provided and must remain posted for 30 days.

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2023
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 03/03/2023 09:48 AM - It Cannot Be Edited


Created By: Keturah Lane On 03/03/2023 at 09:20 AM
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: CARPENTER, VIVIAN FAMILY CHILD CARE
FACILITY NUMBER: 372010482

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/17/2023
Section Cited
CCR
102417(b)

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102417 Operation of a Family Child Care Home (b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

This requirement is not met as evidenced by:
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Facility representative Electra Carpenter stated that they would remove the clutter in the kitchen area and send pictures to LPA Lane via e-mail: Keturah.Lane@dss.ca.gov by 3/17/23
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Based on LPA observation, the licensee did not comply with the section cited above in kitchen and immediate surrounding area where visible clutter was covering counters and immediate vicinity which poses a potential health, safety or personal rights risk to persons 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 Cuddy
LICENSING EVALUATOR NAME:Keturah Lane
LICENSING EVALUATOR SIGNATURE:
DATE: 03/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023


LIC809 (FAS) - (06/04)
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