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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300437
Report Date: 03/10/2022
Date Signed: 03/10/2022 01:01:43 PM

Document Has Been Signed on 03/10/2022 01:01 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MILLER FAMILY CHILD CAREFACILITY NUMBER:
376300437
ADMINISTRATOR:MILLER, HOWARDPHILLISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 575-6634
CITY:OCEANSIDESTATE: CAZIP CODE:
92056
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
03/10/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Licensee, Howardphillisa MillerTIME COMPLETED:
01:15 PM
NARRATIVE
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On 3/10/22 while conducting a complaint investigation on another matter, Licensing Program Analyst's (LPA’s) Linda Almaraz and Sumayya Habeebulla, were conducting a tour of the home and noticed a child facing the wall in a seating chair inside the kitchen area, which is an off-limit area. The stairs that lead to the second floor, which is an all off-limit area were not barricaded and accessible to children. Once the LPA's and Licensee completed the second floor tour, about 18 minutes later, upon entering the garage, there was a child alone in the garage with the door close in a bouncer seat. The child is 2 years old. The child was by themselves with no supervision. In the garage were several poisonous items and chemicals such as Raid sprayers for bugs, Lysol cleaners, Fabuloso, laundry detergent, and grass fertilizers. Per Licensee, she placed the child in the garage to change the child and forgot about the child once the LPA's knocked on the door because she was putting the dogs from outside into her room. Licensee stated the garage is where she normally changes all the children's diapers. The child that was facing the wall in the kitchen was also going to be changed, per Licensee. This child wears pull-ups. Upon reviewing records, LPA's discovered both children were siblings. Kitchen and Garage are both off limit areas. Also observed, a trampoline in the backyard which licensee states they do not use. LPA obtained a statement from the Licensee stating the children will not use it and will ensure they do not access it.

See LIC809D for cited deficiencies. Appeal rights were discussed, and a copy was provided.



An exit interview was conducted, and a copy of this report was provided on this date.

Notice of Site visit was provided and shall remain posted for 30 days.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Linda M Almaraz
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2022
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 03/10/2022 01:01 PM - It Cannot Be Edited


Created By: Linda M Almaraz On 03/10/2022 at 10:43 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MILLER FAMILY CHILD CARE
FACILITY NUMBER: 376300437

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/11/2022
Section Cited
CCR
102417(a)

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102417(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times.
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Licensee will send a written letter to the department stating she has reviewed the regulation and will ensure complete supervision of the children at all times.
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This requirement was not met as evidence by: Based on observation Licensee left 2 children unsupervised in off limit areas. One child was seated on a bouncer and left in a garage with the door closed shut. The other child was on a chair facing the wall in the kitchen area.
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Type A
03/11/2022
Section Cited
CCR102423(a)(4)

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102423(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived ... These rights include, but are not limited to, the following:(4) To be free from corporal or unusual punishment, infliction of pain, humiliation, ....or aids to physical functioning.
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Licensee will send a written letter to the department stating she has reviewed the regulation and will ensure no child will be placed in isolation at any time.
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This requirement was not met as evidence by: Based on observation Licensee had a child facing the wall in a chair by themselves in an off limit area and the sibling of the child in a bouncer in the garage with the door closed in what appeared to be a form of punishment.
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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:Carlos Martinez
LICENSING EVALUATOR NAME:Linda M Almaraz
LICENSING EVALUATOR SIGNATURE:
DATE: 03/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/10/2022


LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 03/10/2022 01:01 PM - It Cannot Be Edited


Created By: Linda M Almaraz On 03/10/2022 at 12:03 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MILLER FAMILY CHILD CARE
FACILITY NUMBER: 376300437

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/17/2022
Section Cited
CCR
102417(g)(10)

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102417(g)(10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Section 1596.846(b) and (c).
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Licensee agrees to remove the bouncers from the facility and agrees not to use them at the facility in the future.
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This requirement was not met as evidence by: Based on observation Licensee had strapped and seated 1 child in a bouncer and had seated the other one in a bouncer inside the garage.
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Type B
03/17/2022
Section Cited
CCR102416.3(a)(6)

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102416.3 (a) Prior to making alterations or additions to a family child care... the licensee shall notify the Department...(6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.
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>>> Licensee had forgotten that she had left the child there.
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This requirement was not met as evidence by: Based on observation Licensee had a two year old on a bouncer in the garage and the door was closed shut. >>>
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Licensee agrees to not place children in the OFF LIMIT areas of the facility.
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:Carlos Martinez
LICENSING EVALUATOR NAME:Linda M Almaraz
LICENSING EVALUATOR SIGNATURE:
DATE: 03/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/10/2022


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 03/10/2022 01:01 PM - It Cannot Be Edited


Created By: Linda M Almaraz On 03/10/2022 at 12:22 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MILLER FAMILY CHILD CARE
FACILITY NUMBER: 376300437

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/17/2022
Section Cited
CCR
102417(g)(4)

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(g) The home shall be free from ...conditions which might endanger a child. Safety precautions shall include but not be limited to:(4) Poisons, detergents, cleaning compounds,... which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
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>>> The garage had disinfectant sprays, bug killer sprays, and other poisonous materials which was easily accessible to the child.
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This requirement was not met as evidenced by: Based on observation Licensee had a two year old on a bouncer in the garage and the door was closed shut. >>>
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Licensee agrees not to take children into areas that are OFF LIMITS and has hazardous materials and ensure the garage is key locked at all times.
Type B
03/17/2022
Section Cited
CCR102417(g)(3)

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(g) The home shall be free from ...conditions (3) Where children less than five years old are in care, stairs shall be fenced or barricaded.
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Licensee agrees to place a gate at the foot of the stairs in order to block the access for children and (2) gates blocking the kitchen entrances. Licensee will send in a picture of the gate placed.
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This requirement was not met as evidenced by: Based on observation Licensee did not have a stair barricade placed at the end of the stairs and in the kitchen area which is also off-limit.
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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:Carlos Martinez
LICENSING EVALUATOR NAME:Linda M Almaraz
LICENSING EVALUATOR SIGNATURE:
DATE: 03/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/10/2022


LIC809 (FAS) - (06/04)
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