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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370805563
Report Date: 10/23/2024
Date Signed: 10/23/2024 01:36:49 PM

Document Has Been Signed on 10/23/2024 01:36 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ST. JOHN OF THE CROSS PRESCHOOLFACILITY NUMBER:
370805563
ADMINISTRATOR/
DIRECTOR:		IDANIA WALTERSFACILITY TYPE:
850
ADDRESS:8175 LEMON GROVE WAYTELEPHONE:
(619) 466-8624
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY: 50TOTAL ENROLLED CHILDREN: 13CENSUS: 10DATE:
10/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:41 AM
MET WITH:Idania WaltersTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
NARRATIVE
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On October 23, 2024, at 9:41 a.m., Licensing Program Analysts (LPAs), Angela Nguyen and Jacqueline Macias and Licensing Program Manager (LPM) Tulam Vu conducted an unannounced Annual/ Random Inspection and met with Director, Idania Walters. LPA disclosed the purpose of the inspection and toured the indoors and outdoors of the facility. Facility operates in the following classrooms: #15 (nap room), #16 (Pre-4), #17 (Pre-3). LPA observed 10 children with 2 teacher and religious education teacher in classroom #16 during the inspection. This is a full day program that operates following the yearly schedule of St. John of the Cross Catholic school. Facility operates Monday through Friday from 7:30 a.m. to 4:30 p.m. There were 10 children present with 2 teachers and 1 aide. Director states she would like to request to remove classroom #14 due to the room was converted to a staff lounge.

Furniture and equipment are in good condition. Floors in the facility are clean and safe. Toilets and hand-washing equipment are in safe and sanitary operating condition. One of the toilets in classroom #16 is missing the lid to the toilet tank. Director states she has submitted a work order to replace the toilet tank lid. Paper towels and toilet paper are available. The bathroom is lighted and has ventilation. Disinfectants, cleaning solutions, medications and other hazardous items were made inaccessible to children during time of inspection. Teachers lounge can be used for food preparation area if needed. Solid waste storage containers have tight fitting covers and are in good repair. Playground equipment is age appropriate and in safe condition. The surface of the outdoor activity space is maintained in a safe condition and free of hazards. Facility has smoke and carbon monoxide detectors that meet requirements. The last fire drill was conducted and documented on 9/23/2024. The lock down drill was conducted on 9/17/2024. Director stated that there are no bodies of water on the premises. Director stated that there are no firearms or ammunition allowed or stored on the premises. Children bring their own water bottles and filter drinking water is available both inside and outside of the facility.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ST. JOHN OF THE CROSS PRESCHOOL
FACILITY NUMBER: 370805563
VISIT DATE: 10/23/2024
NARRATIVE
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US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. 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/inspection-process.


A Type B deficiency, California Code of Regulations, (Title 22, Division 12 & Chapter 1), are being cited on the attached LIC 809-D.

An exit interview was conducted and report was reviewed with the Director, Idania Walters . The director was provided a copy of their appeal rights (LIC 9058) and notice of site visit (LIC 9213). Failure to comply with posting requirements shall result in an immediate civil penalty of $100. LPA observed Notice of Site Visit posted on in classroom #16.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ST. JOHN OF THE CROSS PRESCHOOL
FACILITY NUMBER: 370805563
VISIT DATE: 10/23/2024
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Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Capacity and limitations as specified on the license are being maintained. LPA observed children were under supervision, including visual supervision, of a teacher during the inspection. Facility maintains a ratio of one teacher supervising no more than twelve (12) children in care. All staff members have current CPR and Pediatric First Aid with expiration of 08/22/2026. LPA reminded licensee the name of the facility representative and the fully qualified teacher designated to act in the facility representative’s absence shall be reported to the department. LPA reviewed facility sign in /sign out sheets. Director was reminded that the person who signs the child in and out of the facility shall use their full legal signature and record the time of day. LPA reviewed all 10 children files present during the inspection and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. Director stated will submit an updated admission agreement to the department. LPA reviewed all 3 staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training with the exception of 1 aide.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA verified that the lead testing was completed on 1/13/2023 in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Incidental Medical Services (IMS) policy was discussed.Facility is currently administering IMS. Director will work with LPA to submit a plan to the department. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided:

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Angela Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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Document Has Been Signed on 10/23/2024 01:36 PM - It Cannot Be Edited


Created By: Angela Nguyen On 10/23/2024 at 12:15 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: ST. JOHN OF THE CROSS PRESCHOOL
FACILITY NUMBER: 370805563

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 3 staff has been employed with the preschool since 09/2024 without a health screening which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
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DIrector stated that she will provide a health screening form and have staff #1 make an appointment for a health screening and provide proof of health screening to LPA by 11/22/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Angela Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 10/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2024


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