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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629129
Report Date: 06/26/2023
Date Signed: 06/26/2023 02:25:45 PM

Document Has Been Signed on 06/26/2023 02:25 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:THEANO, CELINE FAMILY CHILD CAREFACILITY NUMBER:
376629129
ADMINISTRATOR:CELINE THEANOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 449-4891
CITY:SAN DIEGOSTATE: CAZIP CODE:
92116
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 9DATE:
06/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:TIME COMPLETED:
02:30 PM
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On June 26 at 12:30pm, Licensing Program Analyst (LPA), David Miller conducted an unannounced 1-year required inspection and met with licensee’s helper, Kylie Madrid. LPA disclosed the purpose of the inspection and was led on a tour of the facility. There were 9 children [four (4) infants and five (5) preschoolers] in care and two staff, Kylie Madrid and Charbine Germain. The licensee participated by speaker phone. This facility is a single story, three (3) bedroom, one (1) bathroom home. The entire house is utilized for child care. Hours of operation are Monday - Friday 8:00am - 5:00pm.

The fire extinguisher, smoke detector and carbon monoxide detector met requirements. LPA observed hazardous items inaccessible to children in care. LPA informed licensee poisons shall be placed in a storage area and locked. LPA observed toys and materials available for the children. Licensee utilizes the fenced backyard for outdoor activities. LPA informed licensee children shall be supervised during outdoor activities. There is a pond in the backyard which is made inaccessible to children by a fence. The fence is at least 5 feet high and has a gate that is self-closing, self-latching and opens away from the pond. Licensee stated there are no weapons in the home.

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.

Madrid's first aid and CPR certifications expire 07/23/2024 and mandated reporter certificate expires 07/23/2024. The last fire/disaster drills were conducted and documented 03/14/2023. A review of staff records indicates all staff have required immunization’s and at least one person with a valid CPR/First Aid certification is present in the facility while children are in care.

See LIC809C continuation...
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE: DATE: 06/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2023
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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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: THEANO, CELINE FAMILY CHILD CARE
FACILITY NUMBER: 376629129
VISIT DATE: 06/26/2023
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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.

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.

LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. For general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies were cited.

Exit interview conducted and report was reviewed with Licensee's staff, Kylie Madrid.

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.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2023
LIC809 (FAS) - (06/04)
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