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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136608073
Report Date: 07/20/2021
Date Signed: 07/20/2021 04:44:40 PM

Document Has Been Signed on 07/20/2021 04:44 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:CALEXICO NEIGHBORHOOD HOUSE HAPPY KIDS PREK&DAYCARFACILITY NUMBER:
136608073
ADMINISTRATOR:AVILA, IGNACIAFACILITY TYPE:
850
ADDRESS:506 EAST FOURTH STREETTELEPHONE:
(760) 357-6875
CITY:CALEXICOSTATE: CAZIP CODE:
92231
CAPACITY: 105TOTAL ENROLLED CHILDREN: 0CENSUS: 21DATE:
07/20/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:31 PM
MET WITH:Isabel GarciaTIME COMPLETED:
05:00 PM
NARRATIVE
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On 7/20/21 at 3:31 PM, Licensing Program Analyst (LPA) Gloria Gonzalez and Licensing Program Manager (LPM) Tulam Vu conducted a case management inspection regarding an incident that occurred on 7/6/21.  LPA advised Interim Program Director, Isabel Garcia of the purpose of the inspection. Present during the inspection there were 21 children, Five (5) teachers and one assistant.

On 7/7/21 Facility self reported an Unusual Incident that occurred on 7/6/21 where a 4 year old was left unsupervised in classroom C. A teacher took 3 children to the restroom located outside of the first playground. One child was left in the classroom while he was playing on the floor with a puzzle. The Teacher was not aware the child was left behind until the child's parent came to pick up the child. LPA reviewed records and interviewed 2 staff members, the child in question and the child's parents who confirmed the incident. Based on the information obtained, it was determined that a daycare child was left unsupervised in the classroom for approximately 5-10 minutes.

A Notice of Site Visit (LIC 9213) is to be posted for thirty (30) days. LPA electronically provided this document to the Licensees. 

Type A deficiency was cited per California Code of Regulations, (Title 22, Division 12 & Chapter 1), on the attached LIC 809-D. Upon Receipt, Ms. Garcia shall post copies of this licensing report.
LPA provided Acknowledgment of Receipt of Licensing Reports (LIC9224) which must be provided to parents/guardians of children currently enrolled/children newly enrolled for the next 12 months and kept in each child’s record.

An exit interview was conducted with the Ms. Garcia.  Ms. Garcia was provided a copy of their appeal rights (LIC 9058).
Tulam Vu
Gloria Gonzalez
DATE: 07/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2021
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 07/20/2021 04:44 PM - It Cannot Be Edited


Created By: Gloria Gonzalez On 07/13/2021 at 11:18 AM
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: CALEXICO NEIGHBORHOOD HOUSE HAPPY KIDS PREK&DAYCAR
FACILITY NUMBER: 136608073

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/20/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/15/2021
Section Cited

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101229(a)(1) Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision... No child(ren) shall be left without the supervision of a teacher at any time.
This requirement is not met as evidenced by:
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Based on interviews and records reviewed, the facility did not ensure proper care and supervision, a daycare child was left unsupervised in the classroom for approximatly 5-10 minutues 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:Tulam Vu
LICENSING EVALUATOR NAME:Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE:
DATE: 07/20/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/20/2021


LIC809 (FAS) - (06/04)
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