Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370811719
Report Date: 08/21/2015 12:00:00 AM
Date Signed: 08/21/2015 12:05:59 PM

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:MULLER, MARION FAMILY DAY CAREFACILITY NUMBER:
370811719
ADMINISTRATOR:MULLER, MARIONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 562-7219
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY:12CENSUS: 4DATE:
08/21/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:42 AM
MET WITH:Marion MullerTIME COMPLETED:
12:14 PM
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(3) LPA Richard Gumienny made an unannounced annual/random inspection. Met with Licensee Marion Muller who was supervising four (4) day-care children (1 of whom was under 24 months of age). Licensee stated that there are no new adults living or working in the home over the age of 18 years. A review of staff records on 8/21/15 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances and T.B. test results prior to working and/or residing in the home. Licensee has current CPR & first aid certifications valid through 6/21/16. This single story, 3 bedroom, 2 bathroom home was inspected. The following areas will be used for day care: Living room, kitchen, dining room, hall bathroom, family room ("Play Room") & fully fenced back yard. The master bedroom & bathroom, additional two bedrooms, & garage are off-limits and inaccessible to children by door lock or door knob cover. There is an operational smoke alarm and fire extinguisher as well as carbon monoxide detector maintained in the home. There are ample space, toys, play equipment and napping equipment for children. Licensee stated there are no weapons or bodies of water present on the premises. The home is orderly and has adequate heating and ventilation. The home has a working telephone. Children's records, immunization & facility roster were reviewed. Fire/earthquake drill was conducted within the last six months.

Licensee stated that she is not currently providing Incidental Medical Services to any children in care. LPA advised that should medical services be provided in the future that the Licensee must create a plan of operation to describe these services.
SUPERVISOR'S NAME: Debbie HanesTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Richard GumiennyTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2015
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: MULLER, MARION FAMILY DAY CARE
FACILITY NUMBER: 370811719
VISIT DATE: 08/21/2015
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No deficiencies cited during this visit. Provided Appeal Rights.

LPA reviewed the following with Licensee: Capacity limitations, supervision, unusual incidents, mandated reporting, Assembly Bill 633, SIDS, Shaken Baby Syndrome, Megan's law, AB 2084 Healthy Beverages in Child Care. Licensee is reminded that corporal punishment, smoking, baby walkers, exersaucers, jumpers and bouncy seats shall never be permitted during day-care operation.


Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ My CCL Web Portal: www.myccl.ca.gov
SUPERVISOR'S NAME: Debbie HanesTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Richard GumiennyTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2015
LIC809 (FAS) - (06/04)
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