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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376630125
Report Date: 04/15/2025
Date Signed: 05/06/2025 10:14:11 AM

Document Has Been Signed on 05/06/2025 10:14 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:FLEURINORD, JEAN FAMILY CHILD CAREFACILITY NUMBER:
376630125
ADMINISTRATOR/
DIRECTOR:		JEAN FLEURINORDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(945) 999-1555
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
04/15/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Jean FleurinodTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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This is an amended version of the original report created on (4/15/2025).

On 04/15/2025 at 2:30 pm, Licensing Program Analysts (LPAs), Danielle Anderson and Michelle Hood conducted an unannounced case management inspection with Licensee Jean Fleurinord.

During the initial 10-day complaint inspection on 04/15/2025 at 12:45 pm, the LPAs were greeted by an uncleared female (later identified as Remene Saint Juste Robeli). Saint Juste answered the door and would not allow LPAs entry into the home. Through an interpreter it was determined the licensee was not present. LPAs observed three pre-school age children and two other adult women through the window of the home.

After LPA Hood placed a call to the licensee, he arrived within 20 minutes. LPA Hood disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. The licensee accompanied LPAs inside and out of the facility during this inspection. During the tour of the home, it was determined there were two additional children in the daycare room (bedroom) left alone with Remene Saint Juste Robeli. The safety gate for the stairs and kitchen were open which allowed the children access to off-limit areas. Licensee stated he did not have the children’s files for the department to review. LPAs observed a trampoline in the backyard without the manufacture safety netting. Licensee stated the facility helper Christela Joseph was not available to work today, so he asked Saint Juste to watch the children while he took Joseph to an appointment.

LPA Anderson informed the licensee Jean Fleurinod to provide a copy of this licensing report dated 4/15/25, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next 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 (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the licensee, Jean Fleurinod. See the LIC 809 D pages and LIC 421BG.

NAME OF LICENSING PROGRAM MANAGER: Cynthia Biszant
NAME OF LICENSING PROGRAM ANALYST: Danielle Anderson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/15/2025 03:14 PM - It Cannot Be Edited


Created By: Danielle Anderson On 04/15/2025 at 01:49 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: FLEURINORD, JEAN FAMILY CHILD CARE
FACILITY NUMBER: 376630125

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/15/2025
Section Cited
CCR
102417

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102417 Operation of a Family Child Care Home. Where children less than five years old are in care, stairs shall be fenced or barricaded.

This requirement has not been met as evidenced by:
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Licensee wrote a written declaration stating that he will do to ensure the stairs remain barricaded.
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Based on the LPAs observation, the stairs nor kitchen were barricaded while children were in care.
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Type B
04/15/2025
Section Cited
CCR102421(b)

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102421 Child's Records
(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7).

This requirement has not been met as evidenced by:
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Licensee stated he will submit required paperwork for all children in care to the LPA no later than 4/18/2025.
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The licensee did not have LIC 700 or any other forms for the children in care available to the department for review.
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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.
Cynthia Biszant
NAME OF LICENSING PROGRAM MANAGER:
Danielle Anderson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/15/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/15/2025 03:14 PM - It Cannot Be Edited


Created By: Danielle Anderson On 04/15/2025 at 01:52 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: FLEURINORD, JEAN FAMILY CHILD CARE
FACILITY NUMBER: 376630125

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/15/2025
Section Cited
CCR
102370(d)(1)(2)

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(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, or living or volunteering Obtain a California clearance or a criminal record exemption... Request a transfer of a criminal record clearance
This requirement has not been met as evidenced by:
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Licensee stated the 3 individuals will be printed and associated to the home and transfer prints of Christela Joseph to the facility.
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Based on observation, interview, and record review the licensee did not comply with the section cited above in having 4 uncleared adults present at the facility which poses an immediate health, safety or personal rights 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.
Cynthia Biszant
NAME OF LICENSING PROGRAM MANAGER:
Danielle Anderson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/15/2025


LIC809 (FAS) - (06/04)
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