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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372018024
Report Date: 02/03/2022
Date Signed: 02/03/2022 03:03:52 PM

Document Has Been Signed on 02/03/2022 03:03 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:GORDON, BOBBIE FAMILY CHILD CAREFACILITY NUMBER:
372018024
ADMINISTRATOR:BOBBIE GORDONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 789-9732
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 15CENSUS: 10DATE:
02/03/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Licensee, Bobbie Gordon TIME COMPLETED:
01:10 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Jennifer Lott and Patrick Ma conducted an unannounced case management visit to cite unrelated deficiencies noted during a previous visit from 10/25/2021. Licensee, Bobbie Gordon was informed of the violation. On or about 10/25/2021, and based on outside source interviews, it was determined that the licensee forces children to eat all items on their plate whether hungry or not. This is a violation of a child’s personal right to be free from corporal or unusual punishment which includes interference with eating.

Therefore, a deficiency is being cited per Title 22, Div. 6, Chap 6 Regulations and listed on LIC 809-D. An exit interview was conducted with Licensee, Bobbie Gordon and a copy of this report along with the Appeal and Licensee's Rights (LIC 9058, 01/16) were provided. A notice of site visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2022
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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Document Has Been Signed on 02/03/2022 03:03 PM - It Cannot Be Edited


Created By: Jennifer Lott On 02/03/2022 at 07:35 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: GORDON, BOBBIE FAMILY CHILD CARE
FACILITY NUMBER: 372018024

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/24/2022
Section Cited
CCR
102423(a)(4)

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To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature including but not limited to: interference with eating…This requirement is not met as evidenced by:
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Licensee will find a certified vendor and attend personal rights training. Proof of this training will be provided to LPA via fax or email by POC date.

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Based on interviews with outside sources, it was discovered that the licensee violated children’s personal rights by forcing them to eat all the food on their plate. This poses an potential personal rights 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:Tashima Daniel
LICENSING EVALUATOR NAME:Jennifer Lott
LICENSING EVALUATOR SIGNATURE:
DATE: 02/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/03/2022


LIC809 (FAS) - (06/04)
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