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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372000311
Report Date: 03/24/2022
Date Signed: 03/25/2022 07:37:05 AM


Document Has Been Signed on 03/25/2022 07:37 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:LA JOLLA PRESBYTERIAN CHURCH PRESCHOOLFACILITY NUMBER:
372000311
ADMINISTRATOR:BARBARA ETIENNEFACILITY TYPE:
850
ADDRESS:7715 DRAPER AVENUETELEPHONE:
(858) 454-2677
CITY:LA JOLLASTATE: CAZIP CODE:
92037
CAPACITY:64CENSUS: 8DATE:
03/24/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
12:21 PM
MET WITH:Barbara Etienne, DirectorTIME COMPLETED:
02:00 PM
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On 3/24/22 at approximately 12:21 PM, Licensing Program Analyst (LPA) Daniel Pena conducted an unannounced case management inspection. LPA was met at the entry point by Director Barbara Etienne. LPA introduced himself, displayed his department identification and explained the purpose of the visit. The purpose of this visit was to review California Department of Public Health (CDPH) Guidelines regarding Covid-19. LPA was provided a tour of the facility. LPA observed the facility was within ratio & capacity.

The classrooms were toured, and LPA observed physical distancing, hand-washing stations and sufficient and current resources on hand. Covid-19-related safety and informational posters are visibly posted for parents, children and staff. Per the director, facility staff, parents and children are routinely reminded of proper procedures to ensure safety.

Following the tour, LPA discussed with Director Etienne current COVID-19 guidance including but not limited to masking, vaccines, food service, visitors, isolation for illness, and responding to positives and outbreaks. Director is aware that mask use is strongly recommended. LPA provided the director with COVID-19 printouts of CDPH guidance and the weblink to the current guidance https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Child-Care-Guidance.aspx). LPA also discussed and provided the Director with printouts of Provider Information Notices (PIN) 22-01.1-CCLD, and 22-10-CCP related to current COVID-19 guidance.

When asked, the Director outlined the COVID-19 protocols that have been implemented at the center to include but not limited to; curbside pickup for parent drop off/pick up to minimize exposure, hospital grade sanitizer used for disinfection, outdoor teacher sanitizes in between groups and individual toys are provided to each cohort, air purifiers are utilized and all windows are open to improve ventilation.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Daniel PenaTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
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: LA JOLLA PRESBYTERIAN CHURCH PRESCHOOL
FACILITY NUMBER: 372000311
VISIT DATE: 03/24/2022
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No deficiencies were cited during this inspection.

Exit interview conducted and report was reviewed with the Director Etienne. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Daniel PenaTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2