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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629212
Report Date: 11/01/2021
Date Signed: 11/01/2021 10:52:21 AM

Document Has Been Signed on 11/01/2021 10:52 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:DRY, PATRICK FAMILY CHILD CAREFACILITY NUMBER:
376629212
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/01/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Patrick DryTIME COMPLETED:
11:00 AM
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On 11/01/21 at 9:00am, Licensing Program Analysts (LPAs) Rajani Goudreau and Cindy Meier conducted an announced Pre-licensing inspection with applicant, Patrick Dry. Also present at the time of the inspection was, Santia Olivier. The purpose of the inspection is to ensure the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This one story, three bedroom, two bath home was toured and inspected. The hours of operation are Monday through Saturday, 7:00 a.m. to 7:00 p.m.

Applicant will utilize the following areas for child care: living room, dining room, bedroom #2, and bathroom #1. Off limit areas included: Master bedroom #1, bedroom #3, hallway, kitchen, and bathroom #2. These areas are made inaccessible to day care children through the use of doorknob covers and a safety gate. Applicant will utilize front yard for outdoor activities, it is properly fenced. LPA informed applicant to ensure children are supervised at all times during outdoor activities. There is a fireplace on the premises which is barricaded and inaccessible to children. Applicant stated there are no bodies of water and LPA did not observe any bodies of water. The fire extinguisher is rated 3A10B:C and is located in the kitchen, smoke and carbon monoxide detectors meet requirements and are operational. Poisons, detergents, cleaning compounds, and medicines are inaccessible to children in care and are in off limit areas with safety gate and secured out of reach of children. Children’s toys and play equipment are available. The applicant has a working telephone/cell phone. Applicant stated there are no firearms, other weapons or ammunition in the home.
Applicant maintains documentation of proof of control of property for review by the Department. Applicant completed Mandated Reporter AB1207 training on 9/17/2021. Applicant completed 8 hours of preventative health which included nutrition and lead training on 8/21/2021. See LIC809-C continuation page…
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2021
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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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: DRY, PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 376629212
VISIT DATE: 11/01/2021
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Pediatric CPR and First Aid certifications expire on 8/23/2023. Immunization records per SB792 were reviewed and met regulations. Required documents are posted. Applicant and adult residents in the home have criminal record clearances and/or exemptions on file. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon their 18th birthday must be fingerprinted cleared and associated to the facility. LPA advised applicant that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. Applicant states they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes.

Applicant does not plan on providing Incidental Medical Services (IMS) to clients at this time. 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 California Megan's Law and provided licensee the following website: www.meganslaw.ca.gov.

The New Provider Resource Packet was reviewed with the applicant including information on the following: PIN20-24-CCP Safe Sleep Regulations, lead exposure, SIDS, shaken baby, child abuse reporting, community resources, children’s records, facility records, required postings, immunizations, unusual incident report, facility roster, car seat law, visual for ratio/capacity, fire/disaster drill log. Applicant was also informed the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care. LPA provided applicant PIN21-18-CCP: Updated Coronavirus 2019 (Covid-19) Industry Guidance for Child Care Settings, along with the COVID Self-Assessment. LPA discussed Guardian with applicant: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian, along with providing PIN 21-02-CCLD Updates to the Implementation of Guardian.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2021
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: DRY, PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 376629212
VISIT DATE: 11/01/2021
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LPA discussed the maximum capacity for a small family child care home: four infants only (infants mean any children under 24 months); or six children with no more than three infants; or, with landlord consent, eight children with no more than two infants, one child in kindergarten or elementary school and one child at least age six, including children under age 10 who live in the home. Landlord Consent (LIC9149) is on file.

Applicant is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov and ttps://www.cdss.ca.gov/inforesources/community-care-licensing for quarterly updates and updated regulation information. San Diego Regional Office Duty Line was provided: (619) 767-2248.

Southern California Child Care Advocate information was provided, and applicant was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

A Regular Small Family Child Care Home license may be issued upon final file review. LPA Meier explained inspection report to applicant, applicant stated he understood. An exit interview was conducted, and a copy of the report was provided to the applicant, Patrick Dry.


SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2021
LIC809 (FAS) - (06/04)
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