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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627900
Report Date: 09/06/2023
Date Signed: 09/06/2023 05:30:07 PM

Document Has Been Signed on 09/06/2023 05:30 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:CAMPOS, CLAUDIA FAMILY CHILD CAREFACILITY NUMBER:
376627900
ADMINISTRATOR:CLAUDIA CAMPOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 642-6919
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
09/06/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:58 PM
MET WITH:Claudia CamposTIME COMPLETED:
04:37 PM
NARRATIVE
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On 09/06/2023 at 3:58 PM LPA Dana Stevens conducted an unannounced Case Management Inspection for the purpose of citing deficiencies noted during a complaint inspection.

Upon arrival LPA was greeted by Licensee's assistant who informed LPA that Licensee had just left the facility to pick up a daycare child and would return shortly. Licensee's assistant granted LPA entry into the facility and LPA observed 11 children present including 4 infants under two years of age.
Licensee arrived at the facility with one more daycare child approximately 12 minutes after LPA's arrival.

During Licensee's absence from the facility, Licensee's assistant was left alone with 11 children including 4 infants under two years of age which made the facility out of compliance with capacity/ratio requirements.

California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 809-D.

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.

Exit interview conducted and copy of report provided to Licensee.

Notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2023
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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Document Has Been Signed on 09/06/2023 05:30 PM - It Cannot Be Edited


Created By: Dana Stevens On 09/06/2023 at 04:28 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: CAMPOS, CLAUDIA FAMILY CHILD CARE
FACILITY NUMBER: 376627900

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/13/2023
Section Cited
CCR
102416.5(b)(3)(a)

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102416.5(b)(3)(a)Staffing Ratio and Capacity…the maximum number of children…shall be one of the following:...More than six and up to eight...only if the criteria in Section 1597.44 of the Health and Safety Code are met...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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Licensee returned to facility 12 minutes after LPA's arrival which put the facility back in compliance with capacity/ratio requirements. Licensee will provide LPA with a written plan of how she will avoid this situation in the future and remain in compliance with capacity/ratio requirements when she is transporting daycare children.
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Licensee's assistant was left alone with 11 children including 4 infants under 2 years of age, which poses an immediate health and safety risk to children 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:Cynthia Gray
LICENSING EVALUATOR NAME:Dana Stevens
LICENSING EVALUATOR SIGNATURE:
DATE: 09/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/06/2023


LIC809 (FAS) - (06/04)
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