Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376614962
Report Date: 04/12/2018
Date Signed 04/12/2018 12:36:00 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:FORD, JANICE FAMILY CHILD CAREFACILITY NUMBER:
376614962
ADMINISTRATOR:JANICE FORDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 449-1362
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY:14CENSUS: 4DATE:
04/12/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Janice FordTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Vicky Williamson made an unannounced Annual/Random inspection. Met with Licensee Janice Ford . During this inspection there were 4 children present, 1 of whom was under 24 months.

This two story, 4 bedroom, 3 bathroom home was inspected. The following areas will be used for day care: living room, play room, side room (adjoining to living room),dining room, bathroom 1 (hallway), front patio,iand fully fenced back yard. Off limits area: entire second story which includes bedroom 1, bedroom 2, bedroom 3, bedroom 4, bathroom 2 ( hallway), bathroom 3 (inside of bedroom 2). Second story is made inaccessible to children through the use of a safety gate at stairway. The garage and kitchen, are off-limits and inaccessible to children by door locks, safety gate and door knob covers. There is a fireplace in the "play room" that is barricaded. There were no bodies of water on the property during the time of inspection. There is a working fire extinguisher rated 2-A :10B:C located in the kitchen, smoke and carbon monoxide detector are present and operational. 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 there are NO firearms or weapons in the home. Licensee maintains a current facility roster of the children, which LPA obtained during time of inspection. Children’s records and immunization cards were reviewed and are in compliance. License states that a copy of the Family Child Care Notification of Parent Right’s is provided to parents. Licensee has pediatric CPR/First Aid certifications valid through 12/2018. Last fire/disaster drill conducted on 2/2/18.

Licensee stated there are no new adults living in the home over the age of 18 years. A review of staff records on 4/12/18 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: 04/12/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2018
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: FORD, JANICE FAMILY CHILD CARE
FACILITY NUMBER: 376614962
VISIT DATE: 04/12/2018
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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.

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.

No deficiencies cited during today's inspection. LPA reviewed this report with Licensee and an exit interview was conducted. The licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their 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

LPA discussed Mandated Reporter AB 1207 training with Licensee. Licensee was issued an Advisory Note, and reminded to complete training no later than April 30, 2018.


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

DATE: 04/12/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2018
LIC809 (FAS) - (06/04)
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