370805679-10-11-2019-51-CC-VWIN-BGUUFB-20191011153227

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 370805679
Report Date: 10/11/2019
Date Signed: 10/11/2019 03:32:32 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:	HOLY TRINITY EARLY CHILDHOOD DEVELOPMENT CENTER		FACILITY NUMBER:	370805679
ADMINISTRATOR:	EDELBROCK, DEBBIE		FACILITY TYPE:	850
ADDRESS:	523 BALLARD STREET		TELEPHONE:	(619) 444-1052
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92019
CAPACITY:	30	CENSUS: 30	DATE:	10/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:46 PM
MET WITH:	Debbie Edelbrock		TIME COMPLETED:	03:40 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	Licensing Program Analyst (LPA) Vicky Williamson conducted an annual random inspection. LPA met with Director, Debbie Edelbrock. There were 30 children present with 3 teachers. Appropriate ratios and capacity were observed. Children were observed to be under visual supervision. The facility operates Monday - Friday from 7:00 am to 4:00 pm. The indoor and outdoor of the facility was inspected. The classrooms and restrooms have adequate lighting, heating, and ventilation. All floors appeared to be safe and clean. Furniture, children's cubbies, toys and napping equipment (mats) appeared to be in good condition. Trash cans have tight fitting covers and are in good repair. Disinfectants, cleaning solutions and other hazardous items are stored behind latched cabinets. Children bring their own lunch and snack is provided by the facility. Snack menu is posted monthly. All food was inspected and protected from contamination. Sign in/out sheets were reviewed showing parent/guardian’s signature and time of day recorded. The kitchen and storage areas appeared to be clean. Facility appeared to be free of flies, other insects and rodents. The surface of the outdoor activity space is maintained in a safe condition with sufficient shade. Drinking water is available inside the classrooms and outdoor play area. There are no bodies of water and weapons present on the premises. The last fire drill was documented on 5/2018. The director's office is designated for use by children who are ill. A sample of the children's records, including medical assessment and emergency information were reviewed. Staff's records, including transcripts, teacher qualifications and experiences and health screenings were reviewed. Opening and closing staff members have current CPR and First Aid certifications. A review of staff records on 10/11/19 indicated that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019

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: HOLY TRINITY EARLY CHILDHOOD DEVELOPMENT CENTER	FACILITY NUMBER: 370805679
	VISIT DATE: 10/11/2019

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

LPA and Director discussed Safe Sleep, Lead Exposure, SIDS, shaken baby, child abuse reporting, record keeping and teacher/child ratio.

Director also was provided with information on Safe Sleep Regulation Concepts, Provider Information Notice (PIN), Effects of Lead Exposure and Safe Sleep.

Please update and submit forms LIC 308, LIC 309, LIC 610, LIC 500, Plan of Operation and Parent Handbook to Licensing Agency by November 11, 2019.

No deficiencies cited. Facility was provided a copy of the appeal rights form LIC 9058 and the signature on this form acknowledges receipt of these rights. The Notice of Site Visit (LIC 9213) was provided to be posted at the facility for 30 days. LPA observed form LIC 9213 posted.

Director is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. Duty Line was provided: (619) 767-2248.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019

LIC809 (FAS) - (06/04)

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