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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629619
Report Date: 09/28/2023
Date Signed: 09/29/2023 08:06:28 AM

Document Has Been Signed on 09/29/2023 08:06 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:VERNE, VERDINORD FAMILY CHILD CAREFACILITY NUMBER:
376629619
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/28/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
04:05 PM
MET WITH:Verdinord VerneTIME COMPLETED:
05:45 PM
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On 9/28/2023 at 4:05 p.m., Licensing Program Analyst (LPA), Cindy Meier conducted an unannounced Case Management-licensee initiated inspection with licensee, Verdinord Verne. LPA Meier informed licensee that the purpose of the inspection was for the requested change of capacity. Licensee led LPA on a tour of the facility. There were no children present at the facility during the time of the inspection. Hours of operation are Monday through Sunday 5:00am – 12:00midnight.

On 9/14/2023 a fire clearance was granted for fourteen (14) children. Licensee will use the following areas for childcare: living room, bathroom, kitchen, and backyard. Off Limit areas include: bedroom #1 and are inaccessible to children by use of safety gates, safety latches or doorknob covers. There is no fireplace on the premises. Licensee utilizes the fenced back yard for outdoor activities. LPA informed licensee to ensure children are supervised at all times during outdoor activities. Licensee stated there are no bodies of water and LPA did not observe any bodies of water during the inspection.

Licensee maintains documentation of proof of control of property for review by the Department. Property Owner/Landlord Consent form LIC9149 is not on file, therefore licensee is approved to care for up to twelve (12) children. Licensee is exempt from the Mandated Reporter AB1207 training due to language barrier. Pediatric CPR and First Aid certifications expire on 2/2025. Immunization records per SB792 were reviewed and met regulations. Required documents are posted.

All adults living or working in the home have been fingerprint cleared and associated. Facility roster was available and updated. A total of eight (8) children are currently enrolled. Children's files were reviewed and two (2) out of eight (8) files were incomplete. Fire drills have not been conducted
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2023
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: VERNE, VERDINORD FAMILY CHILD CARE
FACILITY NUMBER: 376629619
VISIT DATE: 09/28/2023
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There is one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. The licensee has not documented infants sleep every 15 minutes.

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.

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.

Incidental Medical Services (IMS) policy was discussed. 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

Per California Code of Regulations, (Title 22, division 12 & Chapter 3) two (2) Type B citations are being cited on the attached LIC 809-D.

Increase in capacity was not granted on this date.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
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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: VERNE, VERDINORD FAMILY CHILD CARE
FACILITY NUMBER: 376629619
VISIT DATE: 09/28/2023
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Exit interview conducted and report was reviewed with licensee, Verdinord Verne. A copy of this report, along with Appeal Rights (LIC9058), were provided. A notice of site visit was given and must remain posted for 30 days. LPA observed that the notice of site visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/29/2023 08:06 AM - It Cannot Be Edited


Created By: Cindy Meier On 09/28/2023 at 04:55 PM
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: VERNE, VERDINORD FAMILY CHILD CARE
FACILITY NUMBER: 376629619

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/28/2023
Section Cited
CCR
10245(J)(1)

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The provider shall supervise infants while they are sleeping....The provider shall physically check on 15 minutes.

This requirement is not met as evidenced by:
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The licensee stated that he will document when infants are sleeping, and submit the Safe Sleep log documentation to the agency by 10/6/2023.
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Based on interview the licensee did not comply with the section cited above as licensee did not document a Safe Sleep log which poses a potential health, safety or risk to persons in care.
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Type B
09/28/2023
Section Cited
CCR102417(9)(A)(1)

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(A) Each family child care home shall conduct fire drills...at least once every six months....1.The licensee shall document the drills...

This requirement is not met as evidenced by:
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Licensee states he will submit a copy of the completed drill log to analyst by 10/06/23.
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Based on interview, the licensee did not comply with the section cited above as fire drills have not been conducted every six months which poses a potential health, safety or personal rights 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:Jason Garay
LICENSING EVALUATOR NAME:Cindy Meier
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2023


LIC809 (FAS) - (06/04)
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