<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370806232
Report Date: 12/13/2023
Date Signed: 12/13/2023 12:05:22 PM


Document Has Been Signed on 12/13/2023 12:05 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:SAINT DAVID'S PRESCHOOLFACILITY NUMBER:
370806232
ADMINISTRATOR:KAREN GARCIAFACILITY TYPE:
850
ADDRESS:5050 MILTON STREETTELEPHONE:
(619) 276-7048
CITY:SAN DIEGOSTATE: CAZIP CODE:
92110
CAPACITY:53CENSUS: 31DATE:
12/13/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Karen GarciaTIME COMPLETED:
12:15 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 12/13/23 at 11:45 AM Licensing Program Analyst (LPA) Adrian Mangina conducted an unannounced Case Management Deficiency visit. The purpose of the visit was to cite facility for not completing an admission agreement, as required for child #1 and for not having completed sign in sheets for all children every day. During the visit LPA met with Director Karen Garcia. The total census observed in the facility was 31 daycare children with 5 teachers supervising outside and in the bathroom. Proper ratios and supervision were observed.

LPA requested that facility staff provide the admission agreement for child 1 and was told that child an admission agreement in the file as required. LPA also reviewed sign in sheets for September 2023 and found that child #1 was not signed in on 9/22/23, child #2 was not signed out 9/14/23, 9/20/23, 9/21/23, child 3 was not signed out 9/15/23, 9/21/23, 9/25/23, and 9/26/23, child 4 was not signed out 9/19/23, child 5 was not signed out 9/19/23 and 9/25/23, and child 6 was not signed out 9/25/23 as required.

See attached LIC 809-D for type B deficiencies cited.

Exit interview conducted and report was reviewed with the facility representative Karen Garcia. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2023
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


Document Has Been Signed on 12/13/2023 12:05 PM - It Cannot Be Edited

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: SAINT DAVID'S PRESCHOOL
FACILITY NUMBER: 370806232

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/15/2023
Section Cited
CCR
101219(a)

1
2
3
4
5
6
7
ADMISSION AGREEMENTS: 101229(A): The licensee and the child's authorized representative shall jointly complete a current individual written admission agreement for the child. This documentation shall be maintained at the child care center and shall be available for review.
1
2
3
4
5
6
7
Licensee states facility uses a checklist for child documennt and will develop a plan to double check that all child files are complete and will train appropriate staff and will provide plan to LPA no later than close of business 12/15/23.
8
9
10
11
12
13
14
Based on record review the Licensee did not comply with the regulation above as Child 1 has no admission agreement in file which poses a potential health, safety or personal rights risk to children in care.
8
9
10
11
12
13
14
Type B
12/15/2023
Section Cited
CCR101229.1(b)

1
2
3
4
5
6
7
SIGN IN AND SIGN OUT: The person who brings the child to, and removes the child from, the center shall sign the child in/out.
1
2
3
4
5
6
7
Licensee states facility will implement a new procedure for sign in/out that requires staff to hand clipboard to parents when children are signed in and out and staff will also record absences for children not present. Licensee will complete training and provide proof to LPA no later than close of business 12/15/23.
8
9
10
11
12
13
14
Based on record review the Licensee did not comply with the regulation above as 6 of 11 children in classroom 4 were not signed inor out properly every day in September 2023 as required which poses a potential health, safety or personal rights risk to children in care.
8
9
10
11
12
13
14
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: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2