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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370806377
Report Date: 09/27/2022
Date Signed: 09/27/2022 03:36:37 PM


Document Has Been Signed on 09/27/2022 03:36 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:JAMUL-DULZURA UNION SCHOOL DISTRICT PRESCHOOLFACILITY NUMBER:
370806377
ADMINISTRATOR:EMERICK, JENNIFERFACILITY TYPE:
850
ADDRESS:14545 LYONS VALLEY ROADTELEPHONE:
(619) 669-7770
CITY:JAMULSTATE: CAZIP CODE:
91935
CAPACITY:44CENSUS: 4DATE:
09/27/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:22 PM
MET WITH:Jennifer Emerick TIME COMPLETED:
04:00 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 09/27/22, at 1:22 a.m., Licensing Program Analyst (LPA), Rajani Goudreau conducted an unannounced Annual Inspection and met with Director, Jennifer Emerick. LPA disclosed the purpose of the inspection and toured the facility; indoors and outdoors. This is a full day and AM half day program which operates on a traditional school year schedule with the Jamul School District. The following ratios were observed: four children with one staff member (director) in module #1 (classroom #1). Classroom #2 (module #2) is currently not in operation due to low enrollment. Days and hours of operation are Monday through Friday from 8:30 a.m. through 11:30 a.m. (half day program) and 8:00 a.m. to 4:30 p.m. (full day program).

There is no swimming pool or other bodies of water on the premises, per observation and directors statement. There are no firearms or ammunition on the premises, per director. Disinfectants, cleaning solutions, and other hazardous items were made inaccessible to the children in care, per observation. No poisons were observed during the inspection. Furniture and equipment in the classroom was observed to be in good condition, free of sharp, loose or pointed parts. The playground equipment and play materials were observed to be in safe condition, age appropriate free of sharp, loose or pointed parts. The surface of the outdoor activity space was observed to be maintained in a safe condition and is free of hazards. All toilets and handwashing facilities were observed to be in safe and sanitary operating condition. There is two restrooms located in classroom #1 for the children’s use. The floors in the facility were observed to clean and safe. The school district provides the program with breakfast, lunch and snack. Solid waste storage containers were observed to have tight-fitting covers and in good repair. Drinking water is available both indoors and outdoors by the use of reusable cups provided brought from home and uncontaminated water supplied by the facility. Areas around high climbing equipment were observed to have sufficient cushioning material by the use of sand to absorb falls. Shade was observed in the outdoor activity space by the use of tree’s and shade kites. Based on observation, the facility has a functioning carbon monoxide detector and a first aid kit that meet statutory requirements. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility, based on the director’s statement and file review.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2022
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 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: JAMUL-DULZURA UNION SCHOOL DISTRICT PRESCHOOL
FACILITY NUMBER: 370806377
VISIT DATE: 09/27/2022
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
The name of the childcare center director has been reported to the Department, per file review. Sign in/out sheets reviewed and observed to have the parent’s/authorized representative’s full legal signatures and record the time of day. Children were observed to be under supervision, including visual supervision. 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. Required postings are posted, per observation.

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.

This facility provides does not provide Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

Provide the following updated forms to the Department by October 27, 2022:
· LIC610 – Emergency Disaster Plan
· LIC309 – Administrative Organization
· LIC500 – Personnel Report
· LIC508 – Criminal Record Statement for the Director.
· LIC215 – Applicant Information for the Director.

No deficiencies issued during today's inspection. Advisory Note issued due to no AB1207-Mandated reporter training on file. LIC9213 – Notice of Site Visit shall be posted for 30 days from today’s date. Exit interview conducted with the director, Jennifer Emerick.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2