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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370805933
Report Date: 07/03/2019
Date Signed: 07/03/2019 05:39:06 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:ALL SAINTS' EPISCOPAL SCHOOL PRE-SCHOOLFACILITY NUMBER:
370805933
ADMINISTRATOR:BATTLES, RENIKAFACILITY TYPE:
850
ADDRESS:3674 SEVENTH AVENUETELEPHONE:
(619) 298-0313
CITY:SAN DIEGOSTATE: CAZIP CODE:
92103
CAPACITY:91CENSUS: 57DATE:
07/03/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:01 PM
MET WITH:Claudia Rubalcava-Gomez/Assistant DirectorTIME COMPLETED:
05:50 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Selina Siao and Elizabeth Rivera conducted an unannounced case management inspection. Present at the time of the visit were 57 children in four different classrooms.
The following ratios were observed: St. Mary had 15 children napping and were supervised by staff Alexsandra Arballo. St. Anne room had 8 children doing art work and were supervised by teacher Karen Nielsen. St. Paul (toddler class) has 11 children that just woke up from nap and were supervised by teacher Racquel Garcia and teacher Julia Karagodin. Teacher April Davis returned back to the room during the inspection. Saint Elizabeth had 23 children supervised by teacher Racquel Garcia, teacher aide Lisa Rubenstein and Substitute teacher Karly Brumley.

Substitute teacher Karly Brumley has the required background clearances but she is not associated to the facility. Civil penalty of $100 will be assessed today.

“Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. “

Appeal Rights (1/16) were discussed and provided. Signature at the bottom of this report confirms receipt. Notice of Site Visit was posted during this visit and will remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: ALL SAINTS' EPISCOPAL SCHOOL PRE-SCHOOL
FACILITY NUMBER: 370805933
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/05/2019
Section Cited
CCR
101170(e)(2)
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All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 101170(f).
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Assistant Director provided the required criminal background clearances transfer forms to Analysts today. She stated that she will be sure to associate a substitute staff to the facility prior to
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This requirement is not met as substitute teacher Karly Brumley who has the required background clearances but is not associated to the facility. This poses an immediate health and safety risk to clients in care.

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allowing the individual to be in the classroom to work with children. The fax confirmation will be kept in the staff's file.
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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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
LIC809 (FAS) - (06/04)
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