Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376624202
Report Date: 03/18/2016
Date Signed 03/18/2016 01:55:02 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:HIBBERT, BARBARA FAMILY CHILD CAREFACILITY NUMBER:
376624202
ADMINISTRATOR:BARBARA HIBBERTFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 761-9982
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY:14CENSUS: 5DATE:
03/18/2016
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Barbara HibbertTIME COMPLETED:
02:00 PM
NARRATIVE
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LPA observed the following deficiencies during an unrelated visit:

Upon arrival LPA observed the garage door open with various items that need to be kept out of reach of children such as pesticides, lawn tools, other tools, detergent, etc. The children were all inside the home at the time and licensee closed the garage immediately upon request. Licensee is reminded to keep the garage closed during operating hours.

The off limits bedrooms were closed however not physically inaccessible to children in care. Licensee is reminded that the rooms must be kept physically inaccessible to children in care. Licensee put up her gate during the visit.

LPA observed child #3 sleeping in a carseat in the family room.

See the attached LIC 809D for the deficiency cited. The licensee was provided a copy of the Appeal Rights and her signature on this form acknowledges receipt of these rights.

Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Carl SheltonTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Mary A RichardsTELEPHONE: 619-767-2208
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2016
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: HIBBERT, BARBARA FAMILY CHILD CARE
FACILITY NUMBER: 376624202
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/18/2016
Section Cited
102417(d)
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Operation of a Family Child Care Home: The home shall provide safe toys, play equipment and materials. LPA observed child #3 sleeping in a carseat in the family room upon arrival.
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Once the LPA commented on it the licensee immediately picked up child #3 and explains that child #3 was just dropped off and she was distracted by my arrival. Licensee understands that children can not sleep in the carseats. Nothing further is needed.
Type B
04/01/2016
Section Cited
Blank
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Intentionally left blank
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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: Carl SheltonTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Mary A RichardsTELEPHONE: 619-767-2208
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2016
LIC809 (FAS) - (06/04)
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