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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629653
Report Date: 07/11/2023
Date Signed: 07/11/2023 05:46:10 PM

Document Has Been Signed on 07/11/2023 05:46 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:KIRBY, KAYLIE FAMILY CHILD CAREFACILITY NUMBER:
376629653
ADMINISTRATOR:KAYLIE KIRBYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 808-8427
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/11/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Kaylie Kirby & Joseph KirbyTIME COMPLETED:
05:45 PM
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On 7/11/23 at 2:00PM, LPA Luigi Gargaro, conducted an announced prelicensing inspection with the applicant and her husband. The purpose of the visit is to ensure the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. The one floor, three bedroom, one bathroom home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Analyst inquired if there are any bodies of water in the home and the applicant replied no. Applicant does have a firearm in the home but it is secured in a locked case and kept separate from ammunition which is also kept in a separate locked area. Analyst reviewed both items and found them to be safely stored. A review of records on this date indicates that all adults or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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. Applicant rents the home and provided proof of control of property in the form of a home lease agreement that she submitted with her original application. First Aid and CPR expire on 03/04/25 for the applicant and her assistant spouse.

Applicant will be using the following rooms for childcare: the kitchen, the dining area, the living room, the master and second bedroom and the home bathroom. The following areas will be off limits: the third bedroom located immediately off the dining area. The bedroom is made off limits with a locking door knob. The facility has a home fireplace in the living room that is made appropriately inaccessible with an installed screen.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/11/2023
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: KIRBY, KAYLIE FAMILY CHILD CARE
FACILITY NUMBER: 376629653
VISIT DATE: 07/11/2023
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The applicant has sufficient day care equipment available. The home has a fenced backyard available for outdoor activities. The yard contains an off limits shed that is made that way with a padlock. There is also an exit door that leads to a separately addressed neighboring home on the same property lot that is also made inaccessible with a bolt and padlock. The applicant has a three step staircase that leads to the yard that she secures with a locking gated kitchen door and a mesh gate at the bottom of the steps for when children under five years old are playing in the yard. Applicant understands she is to escort children under five years old up and down the staircase when accessing or leaving the yard.

The applicant will also use her front yard with garden as an area to do gardening and other projects. As the yard is filled with plants and is not made for traditional free play, applicant understands that activities in the front yard are to only be conducted with direct supervision of the applicant or her assistant at all times the children are using the yard.

LPA discussed the safe sleep regulations with applicant 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 applicant 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. Unusual Incident Reports may be e-mailed to: SDIncidentReports@dss.ca.gov.

Incidental Medical Services (IMS) policy was discussed. For IMS information, see PIN 22-02-CCP. 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 and applicant discussed California Megan's Law and he provided applicant with the website address: www.meganslaw.ca.gov for her to review information regarding her facility on a regular basis.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
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: KIRBY, KAYLIE FAMILY CHILD CARE
FACILITY NUMBER: 376629653
VISIT DATE: 07/11/2023
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LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. The new provider packet was also reviewed with the applicant including information on child abuse reporting, shaken baby syndrome, SIDS, Lead Poisoning Facts and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

An exit interview was conducted and the report was reviewed with the applicant, Kaylie Kirby and her spouse, Joseph Kirby. A fire clearance for a large license was granted by the San Diego Fire Department on 05/22/23. No corrections are needed and as the home is large enough and comfortable to accommodate up to 14 children, a license for 14 will be issued effective today. Community Care Licensing web site: http://ccld.ca.gov.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
LIC809 (FAS) - (06/04)
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