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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600967
Report Date: 02/02/2022
Date Signed: 02/02/2022 02:19:20 PM

Document Has Been Signed on 02/02/2022 02:19 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:CHILDREN'S CHOICE - INFANTFACILITY NUMBER:
376600967
ADMINISTRATOR:FREDA SIMMONSFACILITY TYPE:
830
ADDRESS:1465 EAST MADISON AVENUETELEPHONE:
(619) 442-4014
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY: 19TOTAL ENROLLED CHILDREN: 19CENSUS: DATE:
02/02/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:12 PM
MET WITH:Freda Simmons TIME COMPLETED:
02:30 PM
NARRATIVE
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On 2/2/22 LPAs Annette Sutherland and Tyra Block during an inspection concerning another matter observed a deficiency in the infant room. Several infants were napping on boppies located on the floor instead of in the crib and 1 infant was in the crib.

Staff #4 was not associated to facility.

Type A and B deficiencies cited on LIC 809D

Upon Receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 was provided and must be maintained in each child's file.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2022
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 2
Document Has Been Signed on 02/02/2022 02:19 PM - It Cannot Be Edited


Created By: Annette Sutherland On 02/02/2022 at 01:26 PM
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: CHILDREN'S CHOICE - INFANT
FACILITY NUMBER: 376600967

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/03/2022
Section Cited
CCR
1014303(E)

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101430 3(E)- Infant Care Activities:If an infant falls asleep before being placed in a crib, staff shall move the infant to a crib as soon as possible.This requirment was not met as evidence by:
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Infants will be placed in cribs when napping. Director will provide written plan detailing a napping procedures. It will be submitted by the POC due date 2/3/22.
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Based on observation and interview infants were allowed to nap on the floor on boppies. This poses an immediate helath and safety risk to children in care.
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Type B
02/03/2022
Section Cited
CCR101216(i)(2)

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101216 (i)(2)Personnel Requirements: Request a transfer of a criminal record clearance as specified in Section 101170(f). This requirmetn was not met as evidence by:
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Director will associate staff to infant program and submit proof by POC date of 2/3/22. Proof will be maintained in staff file.
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Based on observation and record review. Staff #4 is clear but not associated the the infant program.
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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:Monica Cuddy
LICENSING EVALUATOR NAME:Annette Sutherland
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2022


LIC809 (FAS) - (06/04)
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