376629723-12-13-2023-20-CC-JARL-CYGNMA-20231213093447

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629723
Report Date: 12/13/2023
Date Signed: 12/13/2023 09:35:06 AM

Document Has Been Signed on 12/13/2023 09:35 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:	HYPPOLITE, JOANNE FAMIY CHILD CARE		FACILITY NUMBER:	376629723
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 2	DATE:	12/13/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	07:30 AM
MET WITH:	Joanne Hyppolite		TIME COMPLETED:	08:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On December 13^th, 2023 at 7:30 AM, Licensing Program Analyst (LPA), Jo Ann Legaspi conducted an unannounced capacity increase inspection. Licensee Joanne Hyppolite was advised of the meeting’s purpose and granted LPA facility entry. Present in the home was the Licensee and two (2) children. The background cleared spouse returned to the home during this inspection Language Link Operator 17039 and the spouse provided Haitian Creole translation services. The licensee has been licensed as a provider of a small license for at least one (1) year. On 10/16/2023, Licensee submitted an application (LIC 279) requesting a capacity increase. The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal on 11/20/2023 for fourteen (14) children. This three (3) bedroom, one (1) bathroom house was toured and inspected. Licensee accompanied LPA on a tour of the home, as shown on the updated facility sketch. The licensee uses the following areas for childcare: the living room, the dining room, one (1) bedroom, the bathroom, and the back room adjacent to the fenced backyard. The off-limits areas include the remaining bedrooms and kitchen. A child safety gate barricades access into the kitchen. The remaining bedrooms have either a door lock or a child safety cover on their doorknobs. The kitchen has a safety gate barring children’s access in this area. The wall heater is screened. There is a stair leading into the childcare room which has only one (1) step. This stair is barricaded with a child safety gate. Three (3) steps lead to an off-limit bedroom. These stairs are barricaded with a child safety gate. Background criminal record clearances were verified and discussed. First Aid and CPR certifications expire in August 2024. The facility has a working fire extinguisher and a combined smoke/carbon monoxide detector. The last safety drill was on 11/03/2023. There are no bodies of water on the premises. Per the Licensee, neither animals/pets nor firearms/ammunition are housed in the facility. The daycare schedule is weekdays 7 AM – 5 PM.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023

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: HYPPOLITE, JOANNE FAMIY CHILD CARE	FACILITY NUMBER: 376629723
	VISIT DATE: 12/13/2023

NARRATIVE

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The Licensee provided proof of control of property. Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the licensee confirms was provided to the property owner/landlord. The licensee obtained a signed Property Owner/Landlord Consent form (LIC 9149).

The Licensee was provided with the Ratio/Capacity Worksheet for a large family childcare home. The Licensee recognizes that the total amount of children simultaneously in the home also includes children who reside in the home. The Licensee acknowledged that if no assistant provider is present at a Large Family Child Care Home, then the Licensee shall comply with the capacity requirements for a Small Family Child Care Home.

Licensees of family day care homes shall ensure that at staff members shall always be onsite when children are present at the facility and shall be present with the children when children are offsite from the facility for facility activities. The Licensee shall ensure the staff member has a current course completion card in pediatric first aid and pediatric CPR issued by the American Red Cross, the American Heart Association, or by a training program that has been approved by the Emergency Medical Services Authority. Prior to employment or initial presence in the childcare home, all employees subject to a criminal record review shall obtain a California clearance or a criminal record exemption as required by law or Department regulations or request a transfer of a criminal record clearance. The Licensee shall have written evidence of a current tuberculosis clearance for all adults in the home during the time that children are under care. The Licensee shall not employ a staff member if they have not been immunized against influenza, pertussis, and measles. Each employee shall receive an influenza vaccination between August 1 and December 1 of each year. The employee may submit a yearly written declaration attesting that they have declined the influenza vaccination. This exemption applies only to the influenza vaccine. Documentation of immunizations is to be maintained in the staff’s facility personnel record. The Licensee shall provide each employee with a copy of the Notice of Employee Rights (LIC 9052 (4/88)) form furnished by the Department. Each employee shall be requested to sign and date the notice form acknowledging receipt. A copy of the signed notice form shall be retained in the employee's personnel record. If the employee refuses to sign the notice form, a dated notation to that effect shall be retained in the employee's personnel record.

The Licensee is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. Community Care Licensing Division (CCLD)

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023

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: HYPPOLITE, JOANNE FAMIY CHILD CARE	FACILITY NUMBER: 376629723
	VISIT DATE: 12/13/2023

NARRATIVE

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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 platforms. 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. The licensee’s email address is already enrolled in the Department’s email program update notification system. Information about the San Diego Licensing Duty Line was provided. The telephone number to the Licensing Duty Line is (619) 767-2248. Southern California Child Care Advocate (SCCCA) information was provided. Advocate information was provided: (916) 654-1541 and childcareadvocatesprogram@dss.ca.gov

In the areas that were evaluated, no deficiencies were observed. Licensure for a capacity of fourteen (14) of children is approved today (12/13/2023). A new license will be generated and mailed to the licensee.

A notice of site visit was given to the licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview was conducted and report was reviewed with the Licensee Joanne Hyppolite.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023

LIC809 (FAS) - (06/04)

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