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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372000413
Report Date: 11/19/2019
Date Signed: 11/19/2019 11:49:48 AM

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:NORTHMINSTER PRESCHOOLFACILITY NUMBER:
372000413
ADMINISTRATOR:HALLE, SHARONFACILITY TYPE:
850
ADDRESS:4324 CLAIREMONT MESA BLVD.TELEPHONE:
(858) 270-3760
CITY:SAN DIEGOSTATE: CAZIP CODE:
92117
CAPACITY:95CENSUS: 75DATE:
11/19/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Sharon Halle, DirectorTIME COMPLETED:
12:00 PM
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Licensing Program Analysts (LPAs) Elizabeth Rivera and Joelle Redding, made an unannounced visit to follow up on a self reported incident that occurred on 11/01/19, wherein a 4 year old child (Child #1) fell off the rings and broke her elbow.

LPAs spoke with the Director and Staff #1, Staff #2, and Staff #3 who were on the playground when the incident occurred. Director stated that she was not present when the incident happened. Staff #1 was standing under the play structure, next to the ring area and saw the incident. Staff #1 stated Child #1 fell down and forward, Child #1 started to cry then Staff #1 assisted Child #1. There were 11 children present at the time.

Staff #2 stated that she was standing between the tree and the play structure by the monkey bar area but she only saw when Child #1 was already on the floor. Staff #3 stated that she was watching a group of boys but giving special attention to Child #2 because he was having a rough day and she didn't see the incident with Child #1. Staff are advised to allow child to cross unassisted and intervene only if the activity becomes concerning, in order for the child to learn. LPAs spoke with Child #1 who verified that she was on the rings trying to get across and also verified that Staff #1 assisted her after the fall. Staff #1 also added that Child #1 has made previous attempts with no injury. Child #1 has since returned to school.

Director provided LPAs a copy of the Doctor's report and a copy of the ouch report provided to parents. No immediate hazards were noted upon evaluation of the play structure and sandbox area but Director stated they are getting a new play structure. Ratios were in place.

No deficiencies are cited at this time.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Elizabeth RiveraTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
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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