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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100432
Report Date: 09/27/2021
Date Signed: 09/27/2021 01:56:13 PM

Document Has Been Signed on 09/27/2021 01:56 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:CAMACARIS, ALEXANDRA FAMILY CHILD CAREFACILITY NUMBER:
376100432
ADMINISTRATOR:ALEXANDRA CAMACARISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 888-1351
CITY:SAN DIEGOSTATE: CAZIP CODE:
92109
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 12DATE:
09/27/2021
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Alexandra CamacarisTIME COMPLETED:
02:05 PM
NARRATIVE
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On 09/27/2021 at 12:20PM, Licensing Program Analyst (LPA) Selina Siao conducted an unannounced random inspection with the Licensee. The home was toured and inspected to ensure an environment safe for the care and supervision of children. Present at the facility were the Licensee, helper Sarah Vachon and 12 day care children. There are no infants or school age children in care. All hazardous items were latched/locked and secured out of reach of children. Licensee stated that there are no weapon in the home and there is a spa located in the backyard with a cover that is locked and inaccessible to children. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances. Licensee’s First Aid and CPR certifications are current due to expire on 06/28/2022 and licensee has completed the online mandated child abuse training on 02/21/2020. All twelve children's records were reviewed and are in ordered. Facility has an updated roster and fire drill log available for review.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include living room, kitchen, bedroom #1 and bathroom #1. Off limits areas include bedroom #2 and #3 and bathroom #2 and areas are inaccessible through use of locking the doors. The facility has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CAMACARIS, ALEXANDRA FAMILY CHILD CARE
FACILITY NUMBER: 376100432
VISIT DATE: 09/27/2021
NARRATIVE
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Per Senate Bill 792 pertaining to immunization, which require all adults in daycare operation to have proof of immunization for; Measles, Pertussis and Influenza. Or a statement declining the annual flu vaccine. Licensee has verification of required immunization.

Incidental Medical Services (IMS) policy was discussed. 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

The following items were discussed with provider: Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. Licensee was provided with information about Heat Related Illness, Sudden Infant Death Syndrome (SIDS), Never Shake a Baby, safe sleep for infants, best practice on supervision, latest car seat poster and effects of lead exposure and reporting responsibilities were discussed. The ABC’S of Safe Sleep: Sleep is Safest: Alone, on their Back in an empty Crib on a firm mattress.

Child Care Providers can sign up for Quarterly Updates and PINS (Provider Information Notices) through the DSS website at www.ccld.ca.gov. LPA discussed California Megan's Law with licensee: www.meganslaw.ca.gov.

See LIC809D for deficiencies:

A Notice of Site Visit was posted during the inspection and it must remain posted for a period or 30 days. Failure to keep notice posted will result in a civil penalty of $100.00. Provided appeal rights to licensee today.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 09/27/2021 01:56 PM - It Cannot Be Edited


Created By: Selina Siao On 09/27/2021 at 01:23 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 STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CAMACARIS, ALEXANDRA FAMILY CHILD CARE
FACILITY NUMBER: 376100432

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/27/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2021
Section Cited
HSC
1597.622(a)(1)

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Employees or volunteers at family day care home; immunization requirements; records; exemptions. Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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Licensee stated that her helper will obtain her required immunization records and she will submit the records to Analyst no later than 10/25/2021.
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This requirement is not met as evidence by that helper S.V. immunization records are not available for review. This poses a potential health and safety risk to clients in care.
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Type B
10/25/2021
Section Cited
HSC1596.8662(4)(b)(3)

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On and after January 1, 2018, a person who becomes an administrator or employee of a licensed child day care facility shall complete the mandated reporter training provided...
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Licensee stated that she will have her helper locate her online mandated child abuse training certificate or take the course. A copy of the certificate shall be submitted to Analyst no later than 10/25/2021.
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This requirement is not met as helper S.V. online mandated child abuse training certificate is not available for review. This poses a potential health and safety risk to 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:Monica Cuddy
LICENSING EVALUATOR NAME:Selina Siao
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2021


LIC809 (FAS) - (06/04)
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