Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370811719
Report Date: 06/13/2018
Date Signed 06/13/2018 03:34:51 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:
06/13/2018
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Marion MullerTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Vicky Williamson made an unannounced annual/random inspection. Met with Licensee, Marion Muller, also present were licensee's minor granddaughter (14 y/o). During this inspection there were 4 children in care (1 of whom was under 24 months of age).

This single story 3 bedroom, bathroom home was inspected. The following areas are used for day care: living room, kitchen, dining room, bathroom 2, family room (play room), front yard, fully fenced backyard. Off limit areas include: bedroom 1 (master), bedroom 2, bedroom 3, bathroom 1 (inside of master), and garage. They are made inaccessible to day care children through the use of door locks and door knob covers. There were no bodies of water observed during the inspection. There is a working fire extinguisher rated 3-A;40B:C located in the dining room, smoke and carbon monoxide detector are presents and operational. Fireplace is properly screened. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children due to being placed in inaccessible areas. Adequate heating and ventilation is provided for day care children. Children’s toys, play equipment and materials are available. Licensee states that the back yard is utilized for outdoor play. The home has a working telephone. Licensee states there are firearms in the home, ammunition stored separately . Licensee maintains a copy of the emergency information card in each child’s records. Licensee has pediatric CPR/First Aid certifications valid through 2/24/20. Mandated Reporter AB 1207 certificate and immunization records were not available for review during the inspection.



Licensee stated there are no new adults living in the home over the age of 18 years. A review of staff records on 6/13/18 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. LPA advised licensee that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18th birthday must be fingerprinted within 30 days
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2018
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/13/2018
Section Cited
CCR
102416.1(a)
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Personnel Records. Personnel records shall be maintained on each employee and shall contain specified information. The requirement is not met as evidence by: Based on LPA's review of Licensee's records, it was determined that Mandated Reporter AB1207 training has not been completed.
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Licensee states she will submit a copy of Mandated Reporter AB 1201 training certificate to the Department, no later than 7/13/18.
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This poses a potential health and safety risk to children in care.
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Type B
07/13/2018
Section Cited
HSC
1597.622(a)(1)
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Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
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Licensee states she will provide proof of immunizations for pertussis and measles to the Department, no later than 7/13/18.
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The requirement is not met as evidence by: Based on LPA's review of Immunization records (pertussis & measles) for Licensee, it was determined that immunization records were not available for review during the inspection. This poses a potential health and safety 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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2018
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: 06/13/2018
NARRATIVE
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LPA reviewed the following with licensee: SIDS, car seat law, reporting requirements and shaken baby syndrome. Licensee was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care.

Licensee is currently not providing IMS at this time. Incidental Medical Services (IMS) policy was discussed. 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.html

*** New immunization law (SB792) was discussed with Licensee. Licensee understands that anyone who provides care and supervision to the children must have immunization records maintained at the facility for: pertussis, measles, and influenza.

See LIC809D for cited deficiencies. LPA reviewed this report with Licensee. Licensee was provided a copy of her appeal rights (LIC 9058 01/16) and her signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed Licensee post notice of site visit. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov

An exit interview was conducted.


SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2018
LIC809 (FAS) - (06/04)
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