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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372001179
Report Date: 02/25/2020
Date Signed: 02/25/2020 02:00:31 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:RAMONA LUTHERAN SCHOOLFACILITY NUMBER:
372001179
ADMINISTRATOR:DEBORAH ABEELFACILITY TYPE:
850
ADDRESS:520 16TH STREETTELEPHONE:
(760) 789-4804
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY:66CENSUS: 27DATE:
02/25/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Deborah AbeelTIME COMPLETED:
02:15 PM
NARRATIVE
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On 2/25/20 at 11:25AM Licensing Program Analysts, Michael Morales-DeSilvestore and Joelle Redding, made an unannounced visit for the purpose of a random annual inspection. During this visit there were 27 children with 3 staff. Facility is within ratio and capacity. Program operates preschool in rooms 1 and 2.

It was discovered today that the facility is no longer using the two front office rooms for the preschool. The capacity for rooms 1 and 2 were remeasured with a maximum capacity of 47 children. (see capacity worksheet)

The furniture, books, games and toys are safe, age-appropriate and in good repair. Rooms were a comfortable temperature during this visit. No hazards were noted. First aid supplies were located in each room. Bathrooms and hand washing areas are in a safe, sanitary and operating condition. Facility provides hot lunches for students. All hazardous items are stored where they are inaccessible to children. The outdoor play area is fenced and has enough cushioning under and around play structures and slides. There is no evidence of rodent or insect activity. The carbon monoxide and smoke detector are operational. There is at least one staff present with a current CPR and First Aid certification. Sign in sheets were reviewed and are in order. LPA observed appropriate supervision in and out of the classroom. A sample of children's records were reviewed for proper licensing forms and staff records for qualifications.
1:00PM SB 792 (staff immunizations) requirement has not been met for 2/3 teachers did not have required staff immunization's on file.

Facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com.
Isolation area is in front office. Effects of Lead Exposure Handout provided for dissemination to parents/guardians.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestoreTELEPHONE: (619) 767-2208
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020
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: RAMONA LUTHERAN SCHOOL
FACILITY NUMBER: 372001179
VISIT DATE: 02/25/2020
NARRATIVE
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This facility does not provide Incidental Medical Services.

Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

See LIC 809D for deficiences.

NOTICE OF SITE VISIT WAS POSTED DURING THIS VISIT AND WILL REMAIN POSTED FOR 30 DAYS.

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestoreTELEPHONE: (619) 767-2208
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020
LIC809 (FAS) - (06/04)
Page: 3 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: RAMONA LUTHERAN SCHOOL
FACILITY NUMBER: 372001179
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/25/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/25/2020
Section Cited

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1596.7995 (a) (1) Commencing September 1, 2016, a person shall not be employed ...not been immunized against influenza, pertussis, and measles.
This requirement is not met as evidenced:
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Based on observation and interview 2 out of 3 staff did not have proof of required immunization which poses a potential health and safety risk to persons in care.
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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: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestoreTELEPHONE: (619) 767-2208
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2020
LIC809 (FAS) - (06/04)
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