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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005101
Report Date: 09/01/2021
Date Signed: 09/02/2021 11:06:20 AM


Document Has Been Signed on 09/02/2021 11:06 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:CARMEL MOUNTAIN PRESCHOOLFACILITY NUMBER:
372005101
ADMINISTRATOR:DONNA TACONIFACILITY TYPE:
850
ADDRESS:9510 CARMEL MOUNTAIN ROADTELEPHONE:
(858) 484-4877
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY:249CENSUS: 188DATE:
09/01/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Donna TaconiTIME COMPLETED:
02:00 PM
NARRATIVE
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This report is signed on 09/02/2021 due to insufficient time on 09/01/2021.

(1) On 09/01/2021 at 9:30am, Licensing Program Analysts (LPAs) Selina Siao and Saraliz Velando conducted an unannounced random inspection. Upon arrival, LPAs met with Director Donna Taconi and proceeded to tour the facility. All required notices, forms and licenses were posted. Appropriate ratios were observed in all classrooms both indoors and outdoors. Furniture and age appropriate equipment is in good condition. Rooms have adequate heating, lighting and ventilation. Storage are readily available, and room accommodates class size. Napping equipment consists of mats. Bathrooms are maintained with operational toilets and faucets with appropriate temperature. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. The children brings their own snack and lunch to school due to COVID. Outdoor play area is a fenced playground with sufficient rubber cushioning under the high climbing structure and there are sand under the swing sets. Climbing structures, swings and slides are securely fixed to the ground. Areas have multiple canopies and trees used for shades. Equipment is age appropriate and separated by age groups, toddlers and preschool. Children has their own water bottle when they are indoor and outdoor. Playgrounds are free of debris or potential hazards. LPA reviewed sign in sheets, first aid supplies and reviewed medication policy and storage. Isolation area is the Director's office. Reporting requirements was also reviewed. All staff members have required background clearances but one of the staff is not associated to the facility.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/02/2021
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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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: CARMEL MOUNTAIN PRESCHOOL
FACILITY NUMBER: 372005101
VISIT DATE: 09/01/2021
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The following items were discussed with provider: Director was reminded that corporal punishment, smoking are not allowed in day care. Director was provided with information about Heat Related Illness, Never Shake a Baby, latest car seat poster and effects of lead exposure and reporting responsibilities were discussed.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website. Please go to www.ccld.ca.gov . LPA discussed California Megan's Law with facility representative :www.meganslaw.ca.gov.

Refer to the next page LIC 809D for type B deficiencies citations. An exit interview was conducted, and appeal rights were provided. A notice of site visit was provided and to be posted at the facility for 30 days. Failure to keep notice posted will result in a civil penalty of $100.00

SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3
Document Has Been Signed on 09/02/2021 11:06 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: CARMEL MOUNTAIN PRESCHOOL
FACILITY NUMBER: 372005101

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/01/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
09/02/2021
Section Cited

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Criminal Record Clearance
All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:
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Request a transfer of a criminal record clearance as specified in Section 101170(f). This requirement is not met as a staff members who has the required background clearances but is not associated to the faciltiy. Civil penalty of $100 is assess. This poses a potential health and safety risk to clients in care.
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that a staff is associated prior to working at the facility.
Type B
09/24/2021
Section Cited

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Modifications to Infant Needs and Services Plan
(a) The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy.
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This requirement is not met as: There are five toddlers in care that are under 2 years old and non of the children has a modification of needs and service plan. This poses a potential health and safety risk to clients in care.
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correction to Analyst no than 09/24/2021.
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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 09/02/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/02/2021
LIC809 (FAS) - (06/04)
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