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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101091
Report Date: 10/30/2023
Date Signed: 10/30/2023 02:07:03 PM

Document Has Been Signed on 10/30/2023 02:07 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:BOULES, HADEL FAMILY CHILD CAREFACILITY NUMBER:
376101091
ADMINISTRATOR:HADEL BOULESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 569-8246
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
10/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Hadel BoulesTIME COMPLETED:
02:20 PM
NARRATIVE
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On 10/30/23 @ 11:50AM, LPA Nancy Diaz conducted an unannounced inspection. LPA disclosed the purpose of the inspection and was granted facility entry by the Licensee. A tour of the home was conducted with Hadel Boules. Observed present today was one day care child. Mrs. Boules' children arrived @ 1:15pm with helper Randa Yaqo. The following areas are accessible to children living room, dining, kitchen, hallway bathroom and front yard. Off-limit areas are: second floor, converted garage and side yard next to converted garage. Facility operates Monday-Saturday; 7AM-Midnight. The licensee was present in the home to ensure that all children are supervised at all times. Facility is within capacity and did not exceed the capacity specified on the license.
There were no bodies of water observed within the premises. Mrs. Boules stated that she does not have weapons in the home.

Detergents, cleaning compounds, medications and other items which could pose a danger to children are stored appropriately and inaccessible to children.
Fire extinguisher and smoke detectors meet State Fire Marshall standards. The carbon monoxide detector present in the home meet the standards established in Chapter 8 of Part 2, Division 12. Home is kept clean and orderly with heating and ventilation for safety and comfort. A locked door was observed at the bottom of the stairs. Licensee provide safe toys, play equipment and materials. The home maintains a working telephone service.

There is a play pen for each infant who is unable to climb out. The play pen was observed to be free from all loose articles and objects. Bumper pads are not used. There are no objects hanging above or attached to the side of the crib. Infants are not swaddled while in care. Infants are supervised while they sleep. The provider check on sleeping infants every 15 minutes. Documentation are maintained in the infant’s file. An individual infant sleeping plan (LIC 9227) is on file for each infant up to 12 months of age. Documentation of infant napping log was also reviewed.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 10/30/2023 02:07 PM - It Cannot Be Edited


Created By: Nancy Diaz On 10/30/2023 at 01:34 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: BOULES, HADEL FAMILY CHILD CARE
FACILITY NUMBER: 376101091

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(1)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (1) Conversion of a garage (either attached or detached) into a "child care" room.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. Mrs. Boules converted her garage. She did not obtain the proper building permit. She also failed to notify the department that she has opened this converted garage to space used by children. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/31/2023
Plan of Correction
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Mrs. Boules stated that she will not allow children in her converted garage effective today, 10/30/23.
Type B
Section Cited
CCR
102416.3(a)(5)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (5) Construction of play equipment including swing sets/climbing structures.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. Mrs. Boules failed to notify the department that the garage is now accessible to children. She also failed to notify the department that she moved the outdoor play area next to the garage. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/06/2023
Plan of Correction
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Mrs. Boules stated that she will move the outside play area back to the front yard. Mrs. Boules was reminded that all equipment (such as the swing or slide) must be attached to the ground. The move will be completed by 11/06/2023.
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:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 10/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/30/2023


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Document Has Been Signed on 10/30/2023 02:07 PM - It Cannot Be Edited


Created By: Nancy Diaz On 10/30/2023 at 01:34 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: BOULES, HADEL FAMILY CHILD CARE
FACILITY NUMBER: 376101091

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Alterations to Existing Building or Grounds
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) 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.

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. Licensee's helper Randa Yaqo did not have the required Pertussis immunization on file. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/06/2023
Plan of Correction
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Mrs. Boules stated that she will have her helper Randa Yaqo obtain documentation that she has Pertussis immunization no later than 11/06/23.
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:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 10/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/30/2023


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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: BOULES, HADEL FAMILY CHILD CARE
FACILITY NUMBER: 376101091
VISIT DATE: 10/30/2023
NARRATIVE
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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 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.

Car seats are only used for transportation purposes and not used for sleeping. Infants are supervised while they sleep.

The outdoor play area is fenced or supervised by the licensee. An isolation area has been designated for children who became ill during the day.

Children’s records were reviewed. Licensee maintains a copy of the emergency information card that contains all of the information specified by the regulation.

Staff records were reviewed. Licensee has completed the mandated reporter training pursuant to Health & Safety Code. Licensee was made aware that the mandated reporter training shall be renewed every 2 years. Helper, Randa Yaqo is exempt from Mandated Reporter Training as her primary language is Iraqi. Staff have been immunized against influenza, pertussis and measles. Licensee’s CPR and First aid is valid thru April 2024.

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.
Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website. Please go to www.ccld.ca.gov and click on Child Care, go under Quick Links and Quarterly Updates, click on “Receive Important Updates” then enter your email address and choose which program(s) you would like to subscribe to and click “subscribe”.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
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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: BOULES, HADEL FAMILY CHILD CARE
FACILITY NUMBER: 376101091
VISIT DATE: 10/30/2023
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Exit interview conducted and report was reviewed with the licensee. A copy of this report, appeal rights and Notice of Site visit was provided. Notice of site visit was posted and must remain posted for 30 days.

On this date, 10/24/23 the California Attorney General – Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California’s Megan’s Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

TYPE B DEFICIENCIES WERE CITED.
Duty Officer: (619) 767- 2248, Monday thru Friday 8am-5pm.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
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