Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376621279
Report Date: 08/08/2018
Date Signed: 08/20/2018 09:37:09 AM

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:LEBARON, LUCY FAMILY CHILD CAREFACILITY NUMBER:
376621279
ADMINISTRATOR:LUCY LEBARONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 271-6837
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY:14CENSUS: 7DATE:
08/08/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Lucy LebaronTIME COMPLETED:
02:40 PM
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LPA Castellon made an unannounced Annual Random inspection and met with licensee Lucy Lebaron. There were 7 child in care. LPA Castellon conducted a tour of the home to ensure compliance with standards established in Title 22 licensing regulations. The facility is using the following area for daycare: the entire first floor. Second floor and living room are properly barricaded via gate and off limits. Licensee was reminded that she may not make any changes to approved daycare areas prior to Department approval.
All cleaners, toxins, medications, poisons and other hazardous substances are inaccessible to children in care and are located in off limits area. Licensee has provided safe toys, play equipment and materials. Home is clean, orderly with adequate heating and ventilation for safety and comfort. Primary telephone is a land line which is operational. There are no bodies of water kept at the facility. Licensee states that there are no firearms or other weapons in the home. Fire extinguisher, carbon monoxide detector and smoke detector are present in the home and meet State Fire Marshall standards. Licensee has all appropriate forms posted. A fully fenced back patio is used for outdoor play. Licensee was reminded to provide direct supervision when these areas are in use. Facility roster is current. Pediatric CPR and First-Aid certificates are valid through 03.19. Emergency disaster drills are practiced and documented monthly. Children’s records were reviewed.
Licensee has provided parents or representatives with a copy of the Family Child Care Notification of Parent’s Rights. There are no new adults living or working in the home over the age of 18 years. All adult residents and helpers have submitted or been cleared for criminal record and child abuse index clearances or exemptions.

LPA reminds licensee of the following: required departmental documents, supervision, clearances, emergency drills, child passenger law, unusual incident/injury reporting, mandated reporting, Assembly Bill 633, SIDS, Database Link IconShaken Baby Syndrome, and Megan's law. Licensee is reminded that corporal
SUPERVISOR'S NAME: Carl SheltonTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: 619-767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2018
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: LEBARON, LUCY FAMILY CHILD CARE
FACILITY NUMBER: 376621279
VISIT DATE: 08/08/2018
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punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation. New adult immunization requirements have been met.


Incidental Medical Services (IMS) policy was discussed. Facility does not provide care for children who require IMS. 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

Forms and trainings may be obtained at ccld.ca.gov

No citations issued on this date.

SUPERVISOR'S NAME: Carl SheltonTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: 619-767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2018
LIC809 (FAS) - (06/04)
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