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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
376617933
Report Date:
06/23/2022
Date Signed:
06/23/2022 10:12:37 AM
Document Has Been Signed on
06/23/2022 10:12 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:
MACE, DINAH FAMILY CHILD CARE
FACILITY NUMBER:
376617933
ADMINISTRATOR:
DINAH MACE
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(858) 689-2435
CITY:
SAN DIEGO
STATE:
CA
ZIP CODE:
92126
CAPACITY:
14
TOTAL ENROLLED CHILDREN:
14
CENSUS:
11
DATE:
06/23/2022
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
08:05 AM
MET WITH:
Dina Mace
TIME COMPLETED:
10:20 AM
NARRATIVE
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On 6/23/2022 @ 8:05AM, LPA Nancy Diaz conducted an unannounced inspection. LPA met with Dinah Mace. Upon arrival, LPA observed 10 children with Dina Mace alone. At 8:22, another child arrived making a total of 11 children. Helper Darlene Morris arrived shortly (@ 8:23AM). A tour of the home was conducted. The following areas are accessible to children daycare room, hallway bathroom and back fenced yard. Facility operates Monday-Friday; 6:30AM to 5:00PM. 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. Mace stated that she does not maintain any 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. Licensee provide safe toys, play equipment and materials. The home maintains a working telephone service.
Mrs. Mace stated that she does not provide care to children under age two.
LPA discussed the safe sleep regulations with licensee Mrs. Mace 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 Mrs. Mace 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.
SUPERVISORS NAME
:
Tashima Daniel
LICENSING EVALUATOR NAME
:
Nancy Diaz
LICENSING EVALUATOR SIGNATURE
:
DATE:
06/23/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/23/2022
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
8
Document Has Been Signed on
06/23/2022 10:12 AM
- It Cannot Be Edited
Created By:
Nancy Diaz
On
06/23/2022
at
09:31 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:
MACE, DINAH FAMILY CHILD CARE
FACILITY NUMBER:
376617933
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
06/23/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above . LPA observed Mrs. Mace supervising a total of 10 children at 8:05AM. At 8:22AM, another child arrived making the total of 11 children in her care. Helper Darlene Morris arrived shortly to correct the ratio. This poses poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date:
06/23/2022
Plan of Correction
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2
3
4
Helper Darlene Morris arrived at 8:22AM and daughter Victoria Mace arrived at 9:20AM. Mrs. Mace stated that she will have her daughter Victoria or helper Darlene arrive on time to ensure that ratio is met at all times.
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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2
3
4
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:
06/23/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/23/2022
LIC809
(FAS) - (06/04)
Page:
2
of
8
Document Has Been Signed on
06/23/2022 10:12 AM
- It Cannot Be Edited
Created By:
Nancy Diaz
On
06/23/2022
at
09:31 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:
MACE, DINAH FAMILY CHILD CARE
FACILITY NUMBER:
376617933
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
06/23/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.
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. At 8:15AM, LPA observed the Air Condition unit located in the play area not secured. This poses a falling hazard to children at play. This condition poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
06/25/2022
Plan of Correction
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Mrs. Mace stated that she will remove the A/C unit or have them secured tightly in place no later than 6/25/2022. Mrs. Mace will submit a photo to show that it was corrected no later than 6/25/2022.
Section Cited
Deficient Practice Statement
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3
4
POC Due Date:
Plan of Correction
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2
3
4
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:
06/23/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/23/2022
LIC809
(FAS) - (06/04)
Page:
3
of
8
Document Has Been Signed on
06/23/2022 10:12 AM
- It Cannot Be Edited
Created By:
Nancy Diaz
On
06/23/2022
at
09:31 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:
MACE, DINAH FAMILY CHILD CARE
FACILITY NUMBER:
376617933
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
06/23/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)1
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
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4
Based on record review, the licensee did not comply with the section cited above. Mrs. Mace has not documented the fire drills conducted since June 2021. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
06/25/2022
Plan of Correction
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Mrs. Mace shall conducted a fire/disaster drill no later than 6/25/2022 and document the drill. She must submit a copy of the fire/disaster drill log to the department no later than 6/25/2022.
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:
06/23/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/23/2022
LIC809
(FAS) - (06/04)
Page:
4
of
8
Document Has Been Signed on
06/23/2022 10:12 AM
- It Cannot Be Edited
Created By:
Nancy Diaz
On
06/23/2022
at
09:31 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:
MACE, DINAH FAMILY CHILD CARE
FACILITY NUMBER:
376617933
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
06/23/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.
This requirement is not met as evidenced by:
Deficient Practice Statement
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3
4
Based on record review, the licensee did not comply with the section cited above. Mrs. Mace did not maintain immunization records for helpers Darlene Morris and Victoria Mace. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
06/27/2022
Plan of Correction
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Mrs. Mace shall obtain immunization record for Darlene Morris and Victoria Mace to show that they are immune to Measles, Pertussis and Influenza. Mrs. Mace shall submit copies to the department no later than 6/27/2022.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above. Mrs. Mace did not maintain a current roster of children in care. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
06/27/2022
Plan of Correction
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Mrs. Mace shall update her Children's Roster (form LIC 9040) and submit a copy to the department no later than 6/27/2022.
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:
06/23/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/23/2022
LIC809
(FAS) - (06/04)
Page:
5
of
8
Document Has Been Signed on
06/23/2022 10:12 AM
- It Cannot Be Edited
Created By:
Nancy Diaz
On
06/23/2022
at
09:31 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:
MACE, DINAH FAMILY CHILD CARE
FACILITY NUMBER:
376617933
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
06/23/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above. Mrs. Mace did not ensure that all parents sign form LIC 995A. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
06/27/2022
Plan of Correction
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4
Mrs. Mace shall conduct a review of her children's records to ensure that all parents reviewed and signed form LIC 995A. She will submit a copy of completed LIC 995A to the department no later than 6/27/2022.
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:
06/23/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/23/2022
LIC809
(FAS) - (06/04)
Page:
6
of
8
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:
MACE, DINAH FAMILY CHILD CARE
FACILITY NUMBER:
376617933
VISIT DATE:
06/23/2022
NARRATIVE
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Car seats are only used for transportation purposes and not used for sleeping.
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. Staff have 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.
Licensee did not maintain information ons staff immunization record to include Measles, Pertussis and Influenza. Licensee’s CPR and First aid is valid thru 9/2023.
Mrs. Mace 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.
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
SUPERVISORS NAME
:
Tashima Daniel
LICENSING EVALUATOR NAME
:
Nancy Diaz
LICENSING EVALUATOR SIGNATURE
:
DATE:
06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/23/2022
LIC809
(FAS) - (06/04)
Page:
7
of
8
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:
MACE, DINAH FAMILY CHILD CARE
FACILITY NUMBER:
376617933
VISIT DATE:
06/23/2022
NARRATIVE
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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
.
Mrs. Mace is currently maintaining an inhaler for one child that only attends the summer. Mrs. Mace shall submit a Plan of Operation for IMS (Incidental Medical Services) no later than June 30, 2022. LPA provided Mrs. Mace an IMS outline today.
Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
A notice of site visit was provided and observed posted and must remain posted for 30 days.
Exit interview conducted with Mrs. Mace. A copy of this report (and appeal rights) were reviewed and provided with Mrs. Mace.
SUPERVISORS NAME
:
Tashima Daniel
LICENSING EVALUATOR NAME
:
Nancy Diaz
LICENSING EVALUATOR SIGNATURE
:
DATE:
06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/23/2022
LIC809
(FAS) - (06/04)
Page:
8
of
8