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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627135
Report Date: 09/07/2021
Date Signed: 09/07/2021 11:37:18 AM

Document Has Been Signed on 09/07/2021 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:LEAL, GENNY FAMILY CHILD CAREFACILITY NUMBER:
376627135
ADMINISTRATOR:GENNY LEALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 471-7193
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
09/07/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Genny Leal, LicenseeTIME COMPLETED:
11:50 AM
NARRATIVE
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On 09/07/2021 at 11:00 a.m., Licensing Program Analyst (LPA), Michelle Hood, made an unannounced inspection to follow-up on reporting requirements with licensee. During an interview on 07/06/2021, LPA obtained information indicated at some point between April 2021 and June 2021, licensee raised concerns to the responsible party regarding bite marks, and scratches on three (3) daycare children. It was determined during this time, licensee failed to report suspected neglect/abuse to the Department. Based on LPA’s interviews, and documents reviewed the facility is being cited. See the LIC 809D.

Licensee was provided appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. Notice of Site Visit (LIC 9213) was provided to be posted at the facility for 30 days. LPA observed form LIC 9213 posted. An exit interview was conducted.

Signature at the bottom of this report confirm receipt.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 09/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/07/2021
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 09/07/2021 11:37 AM - It Cannot Be Edited


Created By: Michelle Hood On 09/07/2021 at 11:01 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: LEAL, GENNY FAMILY CHILD CARE
FACILITY NUMBER: 376627135

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/07/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/04/2021
Section Cited
CCR
102416.2(c)(1)

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102416.2(c)(1) In addition to the events specified H & S 1597.467(b)(1)(A) through (b)(1)(C), the licensee...report the following events to the Dept.: Any suspected child abuse or neglect,...in Penal Code Section 11165.6,...child in care, in addition to reporting requirements pursuant to PC Section 11166. This requirement is not met as evidenced by:
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Licensee will take the AB 1207 Mandated Reporter training and submit completion certificate no later than 10/04/2021. Licensee will watch CDSS video's for Children's Personal Rights in Child Care, Zero to Three and Child Care Reporting Requirements. Licensee will provide LPA with a short summary of each video listed no later than 10/04/2021.
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Licensee’s admission, sometime between April 2021 & June 2021, licensee raised concerns with the responsible party regarding scratches and bite marks on three daycare children in care. Licensee failed to report suspected neglect/abuse to the Dept. This is a potential health & safety risk to children in care.
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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:Cynthia Gray
LICENSING EVALUATOR NAME:Michelle Hood
LICENSING EVALUATOR SIGNATURE:
DATE: 09/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/07/2021


LIC809 (FAS) - (06/04)
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