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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376622213
Report Date: 06/08/2023
Date Signed: 06/08/2023 11:03:51 AM

Document Has Been Signed on 06/08/2023 11:03 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:DOEHNER, KELSEY FAMILY CHILD CAREFACILITY NUMBER:
376622213
ADMINISTRATOR:KELSEY DOEHNERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 473-9897
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
06/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Kelsey DoehnerTIME COMPLETED:
11:20 AM
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On 06/08/2023 at 9:15am, Licensing Program Analyst (LPA) Samantha Clenista conducted an unannounced random inspection. The home was toured and inspected to ensure an environment safe for the care and supervision of children. Upon arrival, LPA met with Licensee, Kelsey Doehner. Also present was Licensee’s helper, Kayla Higgins and Licensee’s husband, Kurt Doehner. There were also 12 children present (1 who was an infant and 4 school-aged children). Appropriate capacity and ratio was observed. Licensee stated her hours of operation are Monday thru Friday, 8:30am-4:30pm.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include the three bedrooms (Classroom #1, #2 and #3), day care bathroom #1 and #2. Off limits areas include: garage, kitchen, dining room, living room, 2 bedrooms, and one bathroom. The off limit areas are inaccessible through use of safety gates or doorknob covers. The home has two separate outdoor yards. One is used for children which had canopies and trees used for shade and sufficient toys and play equipment. There is a separate fenced in area located in the farthest back of the yard/patio which consists of a chicken coup, garden, and greenhouse. Licensee stated that this area is only used for gardening with the children on occasion where direct visual observation is maintained at all times. The home has a fully charged fire extinguisher. There is a smoke and carbon monoxide detector that meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Licensee stated that there are no bodies of water or weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances. Licensee has a current EMSA approved pediatric First Aid and CPR certifications which is valid through 05/20/2025. Licensee, Licensee's husband and helper have immunization records per SB792.

Children’s records were reviewed and are in order. Facility has an updated roster and fire drill log available for review. Licensee last conducted an earthquake drill with the children in care on 01/13/2023. A copy of the facility roster was obtained during today’s inspection.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE: DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/08/2023
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: DOEHNER, KELSEY FAMILY CHILD CARE
FACILITY NUMBER: 376622213
VISIT DATE: 06/08/2023
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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.htm

The following items were discussed with provider: Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. LPA provided the Effects of Lead Exposure to the facility today and reporting responsibilities were discussed. The ABC’S of Safe Sleep: Sleep is Safest: Alone, on their Back in an empty Crib on a firm mattress.

LPA discussed the safe sleep regulations with Licensee discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website at https://cdss.ca.gov/inforesources/community-care-licensing/subscribe. LPA discussed California Megan's Law with provider and advised her to go on the website at www.meganslaw.ca.gov.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/nspection-process.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023
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: DOEHNER, KELSEY FAMILY CHILD CARE
FACILITY NUMBER: 376622213
VISIT DATE: 06/08/2023
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Facility representative Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

See 9102 for Technical Violation for Child #1 not having LIC9227 on file.

Exit interview was conducted with Licensee at conclusion of visit. No deficiency was observed during inspection. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023
LIC809 (FAS) - (06/04)
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