370805801-3-9-2023-20-CC-VWIN-CPRTT8-20230309140019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 370805801
Report Date: 03/09/2023
Date Signed: 03/09/2023 02:00:39 PM

Document Has Been Signed on 03/09/2023 02:00 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	LA MESA UNITED METHODIST CHILDRENS CTR. SCHOOL AGE		FACILITY NUMBER:	370805801
ADMINISTRATOR:	AMY FAGAN		FACILITY TYPE:	840
ADDRESS:	4690 PALM AVENUE		TELEPHONE:	(619) 466-8407
CITY:	LA MESA	STATE: CA	ZIP CODE:	91941
CAPACITY:	35	CENSUS: 0	DATE:	03/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Sarah Fredsti		TIME COMPLETED:	02:00 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 3/9/2023, at 11:05 am, Licensing Program Analyst (LPA),Vicky Williamson conducted an unannounced annual required inspection. LPA met with Office Administrator Sarah Fredsti and toured the facility. During the inspection there were no children present. The program operates year round (fall, winter, spring and summer break). Days and hours of operation are Monday through Friday, 7:30am - 5:30pm. The school age children arrive to the facility at 7:30am and are transported to school. The children return from school at 2:30pm. Furniture and equipment are in good condition. Playground equipment is in safe condition. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Toilets and hand-washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. The facility does not provide snack. Children bring their own snacks. During the full day program, children bring lunch and snack. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. Facility has a functioning carbon monoxide detector that meet statutory requirements. Office Administrator stated there are no swimming pools or other bodies of water on the premises. Office Administrator stated there are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible to children. A review of staff records on this date indicates facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Office Administrator was reminded that all adults 18 and over, 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 Child Care Center. 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.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LA MESA UNITED METHODIST CHILDRENS CTR. SCHOOL AGE	FACILITY NUMBER: 370805801
	VISIT DATE: 03/09/2023

NARRATIVE

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At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at off-site activities. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. Children are under supervision, including visual supervision, of a teacher at all times.
Office Administrator stated that facility maintains a ratio of one teacher supervising no more than 14 children in care. LPA reviewed a sample of children’s files 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. LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles. Facility staff have current documentation of completed mandated reporter training on file.

This facility provides Incidental Medical Services – IMS, however there are no children requiring medication at this time. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 Office Administrator discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, California Megan’s Law (www.meganslaw.ca.gov).

No deficiencies were cited. An exit interview conducted with Office Administrator Sarah Fredsti and a copy of this report, Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit is required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. LPA observed office administrator post Notice of Site Visit on the bulletin board in the lobby.

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 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/process.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

LIC809 (FAS) - (06/04)

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