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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370806460
Report Date: 12/16/2020
Date Signed: 12/16/2020 12:30:54 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:AKA HEAD START - LA MESAFACILITY NUMBER:
370806460
ADMINISTRATOR:OHLY, ROWENAFACILITY TYPE:
850
ADDRESS:7520 EL CAJON BLVD STE 201/203TELEPHONE:
(619) 463-1093
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY:60CENSUS: 0DATE:
12/16/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:14 AM
MET WITH:Clark Carlson, Facility RepresentativeTIME COMPLETED:
11:25 AM
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On December 16, 2020 at 11:14 AM, Licensing Program Analyst (LPA), Marie Hernandez, conducted an unannounced Tele-Conference Case Management Inspection due to the COVID -19 State of Emergency with the Facility Representative, Clark Carlson, to deliver the incident review findings. The facility self reported the incident to the Department. The facility reports that on 02/25/2020 at approximately 9:30 AM, child #1 was placing a pillow on child #2 in a playful manner and the teacher provided child #1 with a warning to stop. The teacher walked over to child #1 and asked child twice to come with her however, the child did not listen to the teacher. It was alleged that the teacher picked up child #1 and held child by his feet and arms. It was alleged that the incident was observed by a witness. Through the course of the incident review, LPA conducted several interviews with the staff, child #1 in question and several day care children. However, the teacher in question and the witness could not be interviewed. The Director stated the child #1 in question did not sustain any bruising or injuries and returned to the facility the next day after the incident. The child #1 in question, several day care children and several staff did not disclose anything inappropriate with the teacher in question. There was conflicting evidence. Although the allegation may have happened or is valid, there was not a preponderance of evidence to prove the alleged violation did or did not occur. This concludes the incident review.

LPA Marie Hernandez explained the case management incident inspection report, and the Representative, Mr. Carlson stated it was understood. An exit interview was conducted, and a copy of the report was emailed to the Representative. The Representative was advised that acknowledgement of the receipt of the report is to be received within 24 hours. NOTE on Facility Signature: SEE FILE FOR ACKNOWLEDGEMENT.
SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Marie HernandezTELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2020
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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