370800120-3-19-2021-20-CC-RGOU-BZ9TX7-20210319150640

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 370800120
Report Date: 03/19/2021
Date Signed: 03/19/2021 03:07:10 PM

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:	CHRISTIAN CREATIVE LEARNING ACADEMY		FACILITY NUMBER:	370800120
ADMINISTRATOR:	PRISCILLA LAGUNA		FACILITY TYPE:	850
ADDRESS:	2920 MAIN STREET		TELEPHONE:	(619) 698-4306
CITY:	LEMON GROVE	STATE: CA	ZIP CODE:	91945
CAPACITY:	70	CENSUS: 10	DATE:	03/19/2021
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	02:04 PM
MET WITH:	Priscilla Laguan		TIME COMPLETED:	03:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 03/19/21 at 2:04 p.m., Licensing Program Analyst (LPA), Rajani Goudreau conducted an unannounced virtual telephone case management -Incident inspection. The purpose of this visit is to follow up on two separate self reported incidents that occurred on 03/05/21 and 03/09/21. Upon visit, LPA met with the Director, Priscilla Laguna and proceeded to virtually tour the facility. At time of visit, there were 10 children in care with three staff members. LPA verified criminal record clearance for the staff present in the facility. The facility is within ratio/capacity limitations. The facility operates Monday through Friday from 6:30 a.m. to 6:00 p.m. The two incidents were self reported to the department by the director within a timely manner. An incident occurred on 03/05/21 at 2:41 p.m., regarding child #1 (C1) - see LIC811 - confidential names list, falling off a stool in the children’s restroom while washing her hands and sustaining a small laceration on the left side of her chin. Staff #1 (S1)- see LIC811 - confidential names list, observed the incident and immediately attended to C1 and assessed the child for injuries. S1 observed a cut on C1’s chin and immediately applied first aid to the injury and notified the director. The director attended to the child, while S1 notified C1’s parents of the incident. C1 was picked up by her parent and taken to the doctors where no stiches or glue were applied to the laceration. LPA reviewed the classroom sign in and sign out sheet for the day of the incident verified there were eight children in care at the time of the incident. The director and S1 stated, there were three children including C1 getting ready to eat snack and five children in the napping area with one staff member. LPA obtained the incident report that was provided to the parent of C1. In addition, LPA virtually inspected the stool and observed the stool to have two steeps, each leg to have an anti-slip leg cap and the stool to be in good repair. LPA observed the sink and the toilet in the children’s restroom to be adult size; therefore, a stool is needed for the children to reach the sink and the toilet. Since the incident, the director indicated the sink and the toilet in the children’s restroom will be replaced to accommodate the height of the children, in order to eliminate the use of the stool. See LIC809-C continuation page...

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2021

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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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: CHRISTIAN CREATIVE LEARNING ACADEMY	FACILITY NUMBER: 370800120
	VISIT DATE: 03/19/2021

NARRATIVE

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According to the director, the remolding of the restroom will take place during a weekend when no children are in care. LPA informed the licensee to report to the department the start and end date of the remodel of the children’s restroom. Based on the information obtained relevant to the incident and interviews conducted with the director and S1, the facility was within ratio limitations, supervision was in place and the staff responded appropriately to meet the needs of the child at the time of the incident.

An incident occurred on March 09, 2021 at 4:00 p.m., regarding an unknown male individual on the roof of the facility. According to the director, she received a telephone call from the neighbor notifying her of the individual on the roof of the facility. The director immediately called 911 and the San Diego Sheriff’s Department responded to the facility within a couple of minutes. At the time of the San Diego Sheriff Department arrival the individual jumped off the roof and landing in the playground area where he was apprehended. The director indicated she informed the parents of the incident at time of pick up. According to the director, no children heard or observed the incident as the children where inside the facility at the time of the incident. There were 14 children in care with two staff members present in the facility at the time of the incident. According to the director, the current policy at the center is for the staff to conduct a sweep of the outdoor play area prior to the children playing outside. The director indicated she thinks the individual entered through one of the two gates near the outdoor play area. Based on observation, the fence gates lead to the public area of the street. The gates are unable to be locked as the gates are used as emergency exits. The director indicated she obtained approval from the Lemon Grove fire department to install crash bars on the inside of the gates to prevent outside access to the property. The facility responded timely and adequately to the incident in order to protect the health and safety of the children in care.

No deficiencies were issued during today's visit. An exit interview was conducted with the director. The following was discussed and will be provided to the director via email: LIC809 report's, Appeal Rights and the Notice of Site Visit. LPA informed the director the Notice of Site Visit shall be posted for 30 days from today's date. COVID-19 State of emergency read receipt notification will be used in place of the directors signature.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2021

LIC809 (FAS) - (06/04)

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