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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372000550
Report Date: 12/14/2022
Date Signed: 12/14/2022 10:36:10 AM


Document Has Been Signed on 12/14/2022 10:36 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:ST. ANDREW'S BY THE SEA PRESCHOOLFACILITY NUMBER:
372000550
ADMINISTRATOR:HEATHER GASNERFACILITY TYPE:
850
ADDRESS:1050 THOMAS AVENUETELEPHONE:
(858) 273-3023
CITY:SAN DIEGOSTATE: CAZIP CODE:
92109
CAPACITY:70CENSUS: 43DATE:
12/14/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Heather GalsnerTIME COMPLETED:
11:00 AM
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 12/14/22 at 10:15 AM, Licensing Program Analyst (LPA) Adrian Mangina conducted an unannounced Case Management inspection, for reported Lead Exceedance. LPA Mangina met with Director, Heather Gasner. Also present in the facility were 43 daycare children and 10 teachers/staff in 6 classrooms. Facility was within ratio & capacity. vLPA interviewed staff and examined the faucets and drinking fountains deemed an Action Level Exceedance. Facility provided facility sketch and required forms (LIC 9275/9276) to Department on 12/12/22.

Faucets and drinking fountains reported with 5.5 ppb or greater lead exceedance levels were as follows:

Water Fountain “B” 11 ppb

Director reported, the water fountain in exceedance was removed on 12/13/22 and will not be replaced. Prior to replacement, the fountains was masked and bagged. All staff were informed not to use the affected fountain for drinking water or food preparation.

Director states that the fountain has not been used since the beginning of covid March 2020. Children bring filled water bottles from home which are refilled using filtered water provided by an outside water company.

(continued on LIC809 page 2)
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L ManginaTELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2022
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 3


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: ST. ANDREW'S BY THE SEA PRESCHOOL
FACILITY NUMBER: 372000550
VISIT DATE: 12/14/2022
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
LIC809 page 2)

See LIC809D for deficiency cited.

Exit interview conducted and report was reviewed with the facility representative, Heather Gasner. A copy of PIN 21-21-CCP will be provided by email. 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: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3
Document Has Been Signed on 12/14/2022 10:36 AM - 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: ST. ANDREW'S BY THE SEA PRESCHOOL
FACILITY NUMBER: 372000550

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/11/2023
Section Cited

1
2
3
4
5
6
7
Written Directives: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.

This requirement is not met as evidenced by:

1
2
3
4
5
6
7
Facility Representative states water fountain was removed 12/13/22.
8
9
10
11
12
13
14
Based on water testing results and interviews, facility tested over the Action Level Exceedance level at 1 water fountain (B) located outside Starfish Classroom. This posed a potential health, safety or personal rights risk to children in care.

8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: 12/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3