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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604613
Report Date: 02/13/2025
Date Signed: 02/13/2025 02:35:01 PM

Document Has Been Signed on 02/13/2025 02:35 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 RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:OCEANSIDE IVEY RANCH PARK ASSOCIATIONFACILITY NUMBER:
374604613
ADMINISTRATOR/
DIRECTOR:		DANIELLY, TONYAFACILITY TYPE:
775
ADDRESS:110 RANCHO DEL ORO DRIVETELEPHONE:
(760) 722-4839
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY: 12CENSUS: 7DATE:
02/13/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Licensee Tonya DaniellyTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
NARRATIVE
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Licensing Program Manager (LPM) Robyn Clark and Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced joint case management visit regarding health and safety concerns with representatives from the Child Care Program and Oceanside Fire Marshall. LPM and LPA were greeted by, identified themselves to, and explained the purpose of the visit with Licensee Tonya Danielly.

During today’s visit, LPA and LPM conducted a health & safety check, interviewed staff, and conducted a tour of the exterior and interior areas of the property which included both the adult day program (ADP) and child day care program currently licensed by the Department. LPA also reviewed client files and inspected medication storage areas which were securely locked and maintained inaccessible to clients. LPA and LPM confirmed that staff who were observed interacting with clients were fingerprint cleared and associated to the facility. LPA and LPM observed that clients of the adult day program did not commingle with clients of the child care program.

During the visit, LPA and LPM observed multiple Ring cameras present in the common areas of the facility used by clients, which included the activity room, the lobby, the craft room, yard and front entrance. In the ADP room #3 there was also a baby monitor. LPM interviewed Care Programs Manager, who provided examples and described to the Department how audio and video surveillance was used to monitor clients while in the facility. Care Programs Manager confirmed that the baby monitor and Ring Cameras have an audio component. Based on observation and interview, the Ring Cameras are triggered by motion and are set to record in 10 minute periods. Care Programs Manager confirmed that the video feed is only accessed by facility staff. A review of client files revealed that there was no documentation to demonstrate that clients or their authorized representatives had consented to the use of video surveillance in the facility.

Continued on LIC809-C page...
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Rebecca A Borunda
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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 02/13/2025 02:35 PM - It Cannot Be Edited


Created By: Rebecca A Borunda On 02/13/2025 at 12:33 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
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: OCEANSIDE IVEY RANCH PARK ASSOCIATION
FACILITY NUMBER: 374604613

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/17/2025
Section Cited
CCR
82072(a)(1)

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82072(a) Each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement has not been met as evidenced by:
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Care Programs Manager understands that the facility's Plan of Operation and Admission Agreement will need to be updated to address camera use and written consent if cameras are to be implemented in the future.
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Based on observation and interviews, the Licensee did not comply with the section cited above in that video cameras with an audio component were present and operational in client accessible spaces. This poses a potential personal rights risk to 7 of 7 clients in care.
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Care Programs Manager will be removing cameras from facility and will be providing before and after pictures to the Department by POC due date of 2/17/2025.
Type B
02/28/2025
Section Cited
CCR82086(a)

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82086 Alterations to Existing Buildings or New Facilities (a) Prior to construction or alterations, all licensees shall notify the licensing agency of the proposed change.
This requirement has not been met as evidenced by:
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Care Programs Manager understands that the Department must be notified of any alterations to the building prior to construction occurring. Care Program Manager will submit a written statement of understanding and LIC9098 to the Department by POC due date of 2/28/2025.
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Based on observation and interview, the Licensee did not comply with the section cited above in that the Licensee did not notify the Department that alterations to the building had occurred. This poses a potential safety risk to 7 of 7 clients 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:Jennifer Lott
LICENSING EVALUATOR NAME:Rebecca A Borunda
LICENSING EVALUATOR SIGNATURE:
DATE: 02/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/13/2025


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 RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: OCEANSIDE IVEY RANCH PARK ASSOCIATION
FACILITY NUMBER: 374604613
VISIT DATE: 02/13/2025
NARRATIVE
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During today's visit, LPA and LPM observed that a wall had been constructed near the facility kitchen. When interviewed by LPA and LPM, Licensee Danielly reported that the wall was installed to restrict ADP client access to the bathroom, and provide exclusive use to children not part of the facility. Danielly further confirmed to LPM that the wall had been constructed in December 2024, and that the Department was not notified prior to making the alteration.

The following deficiencies were cited for cameras with an audio component and not reporting facility alterations and noted on the attached LIC809-D page. Additionally, an LIC9102TV Technical Violation regarding client record keeping was provided.

An exit interview was conducted with Care Programs Manager Christina Paad, whose signature below confirms receipt of a copy of this report, the LIC9102TV and the Licensee Appeal Rights (LIC9058 3/22).
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Rebecca A Borunda
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
LIC809 (FAS) - (06/04)
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