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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626534
Report Date: 05/12/2023
Date Signed: 05/12/2023 10:07:11 AM

Document Has Been Signed on 05/12/2023 10:07 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:PACKER, GREDNA FAMILY CHILD CAREFACILITY NUMBER:
376626534
ADMINISTRATOR:GREDNA PACKERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 229-2035
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
05/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:TIME COMPLETED:
10:15 AM
NARRATIVE
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On 5/12/23 @ 8:30am, 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 Gredna Packer. Observed present today were 5 children. Helper Mirna Morales was also present and was observed providing care. The following areas are accessible to children living room, daycare room, bathroom, First bedroom to the left (for napping) and outside play are. Facility operates M-F; 7:00AM 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.

LPA did not observed bodies of water within the premises. Mrs. Packer 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.

There is a play pen for each infant who is unable to climb out of the play pen. 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, however Mrs. Packer failed to document when she checks on the sleeping infants.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2023
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: PACKER, GREDNA FAMILY CHILD CARE
FACILITY NUMBER: 376626534
VISIT DATE: 05/12/2023
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 provided the safe sleep handout today. This included the sleep plan and 15-minute nap log. 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. Both staff and licensee have not completed the required mandated reporter training pursuant to Health & Safety Code. Licensee was made aware that the mandated reporter training shall be renewed every 2 years. Licensee and staff did not have proof of immunization to show that they have been immunized against influenza, pertussis and measles. Licensee’s CPR and First aid is valid thru October 2023.

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.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
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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: PACKER, GREDNA FAMILY CHILD CARE
FACILITY NUMBER: 376626534
VISIT DATE: 05/12/2023
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. Mrs. Packer stated that she does not maintain medications for the daycare children. 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

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.

TYPE B DEFICIENCIES WERE CITED TODAY.

Exit interview conducted and report was reviewed with facility representative, Gredna Packer. A copy of this report, along with Appeal Rights (LIC9058), were provided. A notice of site visit was also provided, observed posted and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 05/12/2023 10:07 AM - It Cannot Be Edited


Created By: Nancy Diaz On 05/12/2023 at 09:40 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: PACKER, GREDNA FAMILY CHILD CARE
FACILITY NUMBER: 376626534

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(10)
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: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).

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. Observed in the children's area today were two baby rockers. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/12/2023
Plan of Correction
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CORRECTED TODAY.
Mrs. Packer removed the two baby rockers observed in the children's area today. She placed the baby rockers in the garage and stated that she will not use the equipment for infants.
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 interview and record review, the licensee did not comply with the section cited above. Mrs. Packer failed to document the 15-minute check on sleepin infants. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/19/2023
Plan of Correction
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LPA provided handouts on the safe sleep regulation today and went over the new requirements. LPA also provided a sample nap log. Mrs. Packer stated that she will start using the form immediately. Sample nap log (5 days worth) shall be submitted to the department no later than 5/19/2023 via email to:
Nancy.diaz@dss.ca.gov
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: 05/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/12/2023 10:07 AM - It Cannot Be Edited


Created By: Nancy Diaz On 05/12/2023 at 09:40 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: PACKER, GREDNA FAMILY CHILD CARE
FACILITY NUMBER: 376626534

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. Licensee and helper Mirna Morales did not have a current Mandated Reporter Training certificates on file. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/19/2023
Plan of Correction
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Mrs. Packer stated that they will complete the training no later than 5/19/23 and submit proof of course completion via email to: nancy.diaz@dss.ca.gov. Training is available online at mandaredreporterca.com
Type B
Section Cited
CCR
102419(j)
Admission Procedures and Authorized Representatives Rights
(j) Copies of the signed receipt shall be available to the Department as provided in Section 102391(d).

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 did not have form LIC 995a signed by parents on file. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/19/2023
Plan of Correction
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Mrs. Packer stated that she will provide form LIC995A to all parents to obtain their signatures and have them on children's files no later than 5/19/23. Mrs. Packer shall submit copies via email to: nancy.diaz@dss.ca.gov no later than 5/19/23.
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: 05/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/12/2023 10:07 AM - It Cannot Be Edited


Created By: Nancy Diaz On 05/12/2023 at 09:40 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: PACKER, GREDNA FAMILY CHILD CARE
FACILITY NUMBER: 376626534

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 and her helper Mirna Morales did not have proof of being immunized against influenza, measles and pertussis. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/19/2023
Plan of Correction
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Mrs. Packer stated that she will obtain a copy of immunization record for herself and helper Mirna Morales and submit a copy to the department no later than 5/19/23. Documents can be sent via email to: nancy.diaz@dss.ca.gov
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Tashima Daniel
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 05/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2023


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