370806115-9-13-2022-20-CC-RGOU-CJ8N78-20220913101219

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 370806115
Report Date: 09/13/2022
Date Signed: 09/13/2022 10:12:28 AM

Document Has Been Signed on 09/13/2022 10:12 AM - It Cannot Be Edited

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:	CHRISTIAN CHURCH OF LEMON GROVE SCHOOL-AGE PROGRAM		FACILITY NUMBER:	370806115
ADMINISTRATOR:	LYNN LEAVITT		FACILITY TYPE:	840
ADDRESS:	6970 SAN MIGUEL AVENUE		TELEPHONE:	(619) 465-1887
CITY:	LEMON GROVE	STATE: CA	ZIP CODE:	91945
CAPACITY:	60	CENSUS: 0	DATE:	09/13/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Lynn Leavitt		TIME COMPLETED:	10:15 AM

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 09/13/22 at 8:30 a.m., Licensing Program Analyst (LPA), Rajani Goudreau, conducted an unannounced annual Inspection and met with Director, Lynn Leavitt. LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors. There were no children in care at time inspection. This is a full day program that operates year around; Monday through Friday from 7:00 a.m. to 5:30 p.m. During the inspection, no bodies of water were observed on the premises of the property. Director confirmed there were no bodies of water on the premises. Disinfectants, cleaning solutions, medication and other hazardous items were observed to be made inaccessible. No poisons were observed at time of inspection. LPA informed Director all poisons shall be are kept in a locked storage area. Furniture and equipment were observed to be in good condition, free of sharp, loose or pointed parts. All materials and surfaces accessible to children were observed to be toxic free. All toilets and hand washing facilities are in safe and sanitary operating condition, per observation. All floors in the facility are clean and safe, per observation. Food preparation and storage areas were observed to be clean. Drinking water is available both indoors and outdoors through the use of refillable water containers. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space was observed to be maintained in a safe condition and free of hazards. LPA observed areas around high climbing equipment to have sufficient sand to absorb falls. The facility is free of flies, insects and rodents, per observation. Facility has a first aid kit and a functioning carbon monoxide detector that meets statutory requirements. The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. The Department has inspection authority as specified in Health & Safety Code.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

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 3

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: CHRISTIAN CHURCH OF LEMON GROVE SCHOOL-AGE PROGRAM	FACILITY NUMBER: 370806115
	VISIT DATE: 09/13/2022

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
26
27
28
29
30
31
32

A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. All personnel, including the licensee, administrator and volunteers, shall be in good health and are physically and mentally capable of performing assigned task. Personnel that pose a threat to the health and safety of children shall be relieved of their duties. All personnel are trained on housekeeping and sanitation principles, including universal health precautions or have related experience. All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 14 children in care. The licensee ensures children with obvious symptoms related to fever or vomiting are not accepted. The facility is equipped to isolate and care for any child who becomes ill during the day. 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. LPA reviewed a sample of 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.

This facility provides Incidental Medical Services (IMS). There are no children in care receiving IMS services at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Section 101173 and 101226. 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: 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. Services are in place.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, California Megan’s Law (www.meganslaw.ca.gov), Lead Poisoning Facts, Forms and Regulations.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: CHRISTIAN CHURCH OF LEMON GROVE SCHOOL-AGE PROGRAM	FACILITY NUMBER: 370806115
	VISIT DATE: 09/13/2022

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
26
27
28
29
30
31
32

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/inspection-process.

Facility representative 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.

No deficiencies issued during today's inspection. Notice of Site Visit (LIC9213) shall remain posted for 30 days from today's date. Exit interview conducted with Director, Lynn Leavitt.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3