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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100672
Report Date: 03/17/2023
Date Signed: 03/17/2023 11:37:51 AM

Document Has Been Signed on 03/17/2023 11:37 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:BURNS, CHERYL FAMILY CHILD CAREFACILITY NUMBER:
376100672
ADMINISTRATOR:CHERYL BURNSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 313-1285
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
03/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Licensee Cheryl BurnsTIME COMPLETED:
11:45 AM
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On 3/17/2023 at 10:20 p.m., Licensing Program Analyst (LPA), Joelle Redding, made an unannounced visit for the purpose of an Annual Inspection. During this visit, there were 11 children in care with Licensee and two assistants. Three children under the age of two years. The facility is within ratio and capacity.

LPA toured the home. Primary child care areas are the entire home with the exception of the master bedroom and bath, laundry, garage and any outbuildings. The facility sketch on file is accurate. Off limits areas have been made inaccessible with the use of locks or latches. There is a hunting rifle in the detached garage in a locked box with ammunation stored separately in a locked box, inaccessible to children. There are no bodies of water present. The fireplace has been secured. The fire extinguisher is full and of adequate size and located in the pantry. The smoke alarm (located ) and carbon monoxide detector (located ) are operational. Emergency drills are being conducted and logged at least every six months and there is a written Disaster Plan on file. Last drill was conducted on 12/13/22. The home is clean, orderly with adequate ventilation and heating. Licensee has provided enough space for the children to eat, sleep and play within the home. Children bring their snacks and lunches in labeled containers and there is refrigeration available for storage, if needed. The furniture, to include napping materials and children’s toys, books and activities are safe and age appropriate and in good repair. Licensee has checked for recalled items. There is a working telephone and all required forms are posted. Outdoor play space is fully fenced with age appropriate play equipment and activities in good repair. No hazards were noted. Licensee understands there is no smoking in or around day care areas. Children’s files were reviewed and found to be complete. Verification that school age children present are enrolled/attending elementary or above was on file. The facility roster was current and complete and is being stored for 3 years. Licensee's pediatric CPR/FA certificate with Heartsaver, exp. 3/24. Staff files were reviewed and found to be current. Licensee is reminded that Mandated Reporter Training certificates are to be renewed every two years at the following website: www.mandatedreporterca.com. Licensee's certificate exp. this month.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: BURNS, CHERYL FAMILY CHILD CARE
FACILITY NUMBER: 376100672
VISIT DATE: 03/17/2023
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LPA discussed the safe sleep regulations with licensee 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 [facility representative] of the importance of checking for recalled 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. . Licensee is reminded that infants may not be swaddled while in care and walkers, exersaucers, jumpers, bouncy seats, napping portables and drop sided cribs are not permitted for use.

Children will be observed upon entry and throughout the day for signs of illness. An appropriate isolation area has been established for sick children. Reporting requirements for positive Covid-19 results in children or staff were discussed to include contact with County Department of Public Health for guidance (619-692-8499) and Licensing (619-767-2248) to report the unusual incident for THREE or more cases.

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

Licensee 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.

Licensee is to be present in the home to ensure children are supervised and reminded that no children are to be left in parked vehicles and car seats are not to use used for sleeping. . Capacity limitations were reviewed. LPA discussed California Megan's Law and the website was provided as follows: www.meganslaw.ca.gov

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
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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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: BURNS, CHERYL FAMILY CHILD CARE
FACILITY NUMBER: 376100672
VISIT DATE: 03/17/2023
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Licensee is signed up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov.

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.

LPA conducted child care quality management interview with Licensee Cheryl Burns. Exit interview conducted and report was reviewed with the Licensee.

See LIC 809D for deficiencies.

NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/17/2023 11:37 AM - It Cannot Be Edited


Created By: Joelle Redding On 03/17/2023 at 11:29 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: BURNS, CHERYL FAMILY CHILD CARE
FACILITY NUMBER: 376100672

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that there were no sleep logs in place for the three children under two years. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/31/2023
Plan of Correction
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Licensee states that they have been checking the children but not logging it. She will establish a log and initiate the process right away. Documentation of next week's logs will be sent to Licensing by 3/31/23 for verification of corrrection.
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that she did not have the form on file for the 10 month old infant in care. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/31/2023
Plan of Correction
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Licensee states that she will have the parent completed the form right away and a copy will be sent to Licensing by 3/31/23 for verification of corrrection.
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:Renesha Askew
LICENSING EVALUATOR NAME:Joelle Redding
LICENSING EVALUATOR SIGNATURE:
DATE: 03/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2023


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