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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626459
Report Date: 10/18/2022
Date Signed: 10/18/2022 11:54:34 AM

Document Has Been Signed on 10/18/2022 11:54 AM - It Cannot Be Edited

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:SMITH, ANGELA FAMILY CHILD CAREFACILITY NUMBER:
376626459
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
10/18/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:41 AM
MET WITH:Angela SmithTIME COMPLETED:
11:45 AM
NARRATIVE
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On 10/18/2022 at 11:00am Licensing Program Analysts (LPAs), David Miller and Rajani Goudreau conducted an unannounced case management deficiency inspection. Upon arrival, LPAs met with licensee, Angela Smith and disclosed purpose of the inspection. During the inspection there were eight children in care, including one infant and seven preschool aged children.

During the inspection, LPAs observed eight children in care without one child attending kindergarten or elementary school and a second child at least 6 years of age. LPAs conformed ages of children in care with licensee and facility roster. LPA informed licensee of the small license ratio and capacity requirements. Licensee acknowledged understanding of the requirement.

LPA informed the licensee, Angela Smith, that this report dated 10/18/2022 documents one (1) Type A citation on the attached LIC809-D, which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. Also, LPA informed the licensee to provide a copy of this licensing report dated 10/18/2022 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2022
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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Document Has Been Signed on 10/18/2022 11:54 AM - It Cannot Be Edited


Created By: David Miller On 10/18/2022 at 10:47 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SMITH, ANGELA FAMILY CHILD CARE
FACILITY NUMBER: 376626459

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/19/2022
Section Cited
HSC
1597.44(a)

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1597.44 Small family day care homes; number of children. A small family day care home may provide care for...up to eight children...if all of the following conditions are met: (a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age. This requirement was not met as evidenced by:
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LPA informed license if the ratio requirements and provided licensee with a visual handout capacity with the ratio requirements for a small license. Licensee indicated that she will provide an updated facility roster, children’s schedules reflecting times and days they attend to ensure ratio is followed. Plan of correction will be submitted to the San Diego Regional Office by 10/19/2022.
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Based on observation the licensee did not comply with the section cited above as there were eight children in care without one child attending kindergarten or elementary school and a second child at least 6 years of age, which poses/posed an immediate health and safety risk to persons 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 Vu
LICENSING EVALUATOR NAME:David Miller
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2022


LIC809 (FAS) - (06/04)
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