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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629052
Report Date: 03/02/2023
Date Signed: 03/02/2023 11:02:33 AM

Document Has Been Signed on 03/02/2023 11:02 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:CAHA, KATHERINE FAMILY CHILD CAREFACILITY NUMBER:
376629052
ADMINISTRATOR:KATHERINE CAHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 335-6182
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91978
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 8DATE:
03/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Katherine CahaTIME COMPLETED:
11:15 AM
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On March 3rd, 2023, at 9am, Licensing Program Analyst (LPA) David Miller conducted an unannounced Annual Required Inspection and met with the licensee, Katherine Caha. LPA disclosed the purpose of the inspection and was granted facility entry by the Licensee. The licensee and eight (8) daycare children, one under 12 months and seven (ages 1-4) were present in the facility during this inspection. Also present in the home was the licensee's mother, Lisa Turck, who has background clearance.

This is a two story four bedroom and three bath home. The licensee will use the following areas for childcare: The kitchen, living room, dining room, day care room, and the hallway bathroom. The off-limit areas are the upstairs bedrooms #2, #3, bathroom and the master bedroom with the attached bathroom. The downstairs bedroom #1 is off limits via a locked door. The off limit areas are inaccessible to children through the use of a child proof safety gate and locked doors. The home has an in-ground swimming pool and jacuzzi in the backyard; they are inaccessible to the children via an enclosed and secured gate. The patio will be used for outdoor activity of children. The backyard in-ground swimming pool, jacuzzi and the garage are off limits. The licensee was advised that when the children are outside, full supervision must be at all times.

The fire extinguisher and smoke/carbon monoxide detector met requirements. The licensee has available toys, play equipment and materials. Licensee was reminded that continuous supervision is to be given to children whenever engaged in outdoor activities. No bodies of water were observed on the premises during the inspection. Licensee stated there are no weapons in the home and LPA did not observe any firearms at the time of this inspection.

Licensee’s First Aid and CPR certifications expire in February of 2025 Licensee has required immunizations. Licensee completed the mandated reporter training in October of 2022. The facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 02/05/2023.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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: CAHA, KATHERINE FAMILY CHILD CARE
FACILITY NUMBER: 376629052
VISIT DATE: 03/02/2023
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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.

LPA discussed the safe sleep regulations with licensee and 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.

LPA reminded Licensee of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare.

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.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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: CAHA, KATHERINE FAMILY CHILD CARE
FACILITY NUMBER: 376629052
VISIT DATE: 03/02/2023
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No deficiencies cited.

A copy of the report and appeal rights (LIC 9058) was provided to the applicant and notice of site visit (LIC9213) was given to Licensee and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the licensee Katherine Caha. 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 [email protected]. 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/process
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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