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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626459
Report Date: 03/15/2023
Date Signed: 03/15/2023 04:10:19 PM

Document Has Been Signed on 03/15/2023 04:10 PM - 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: 12CENSUS: 0DATE:
03/15/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Angela Smith TIME COMPLETED:
04:10 PM
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On March 15th, 2023, at 3:15 PM, an office meeting was conducted with the licensee, Angela Smith to discuss recent citations issued on December 8th and October 18th, 2022. Present at the meeting was Licensing Program Manager (LPM) Tulam Vu, and Licensing Program Analyst (LPA) David Miller.

On December 8th, 2022 a substantiated complaint Type A violation of the California Code of Regulation (CCR) Section 102423(a)(4) Personal Rights was cited due to licensee violated the personal rights of two children in care by grabbing and pulling two children in a rough manner. On October 18th, 2022 a Type A violation for Health and Safety Code 1597.44 was issued due to licensee was caring for eight children in care without one child attending kindergarten or elementary school.

The Licensee explained measures have been implemented to ensure that she and her staff will abide by the personal rights of daycare children, and that the facility will not operate over capacity. The Licensee stated she reviewed the personal rights regulation and ratio worksheet. Licensee also submitted a plan of corrections, and previously reviewed the Personal Right's Video.

Resources were provided to the Licensee and discussed during this meeting. The Capacity Worksheet for a small and large license was provided and explained to the Licensee again during this meeting.

Additionally, the Licensee was advised of the educational videos located at the following web address: https://ccld.childcarevideos.org/family-child-care-providers/. The video titled “ How Many Children Can Attend a Family Child Care Home?” was discussed.

The Licensee agreed to review the video and provide LPA with a summary of the watched video no later than 03/24/2023. The Licensee was also reminded that EMSA pediatric 1st Aide/CPR must remain current at all times.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2023
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: SMITH, ANGELA FAMILY CHILD CARE
FACILITY NUMBER: 376626459
VISIT DATE: 03/15/2023
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LPM discussed with licensee the seriousness of the above deficiencies. Licensee was provided with the following resources: A Technical Support Program (TSP) brochuremailto:[email protected], CCLD Quarterly Spring Update, Provider Information Notice (PIN) 22-30-CCP, Child Care Advocate (916- 654-1541 or [email protected]).

Report incidents to the following webpage: mailto:[email protected]

Report any unusual incidents or any general questions to the Licensing Duty Line at (619)-767-2248.

Licensee was informed that repeated violations or failure to comply with licensing laws and regulations may result in administrative action taken by the Department. Licensee stated she understood and will ensure the facility complies with all regulations and laws governing Family Child Care Homes.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023
LIC809 (FAS) - (06/04)
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