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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370805864
Report Date: 08/23/2022
Date Signed: 08/26/2022 01:06:53 PM


Document Has Been Signed on 08/26/2022 01:06 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 08/25/2022 02:25 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

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THIS IS AN AMENDED REPORT DELIVERED ON 8/26/22.

On 8/23/22 at 12:00 PM Licensing Program Analyst, Adrian Mangina conducted an unannounced visit to follow up on a self-reported incident that occurred on 8/18/22 wherein child #1 reported to parent that they were grabbed by a teacher and received an injury as a result.

LPA interviewed Director, Assistant Director and staff #2. None of the staff interviewed witnessed the event and none knows exactly what happened. Director stated that she was not at the facility at the time of the incident. Assistant Director informed of the incident when it was reported by the parent. Assistant Director called Director and had Staff #1 speak with Director. Director spoke with staff #1 and asked what happened. Staff #1 stated that the child was trying to jump over a chair and the teacher grabbed the child for fear that the child would hurt themselves. Director stated that the next day staff in question offered to resign and that the Director accepted the staff’s resignation.

There were 13 children present in the classroom with one teacher at the time of the incident. Director stated that she gathered the staff after the incident and discussed ways teachers can address behavioral issues with children without resorting to physically handling a child. Director stated that that she reminded staff that it is a hands off facility and that she is developing a more comprehensive child discipline policy.

Additional information is needed. No deficiencies are cited at this time.
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:
DATE: 08/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/26/2022
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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