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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005101
Report Date: 12/14/2021
Date Signed: 12/14/2021 04:29:19 PM


Document Has Been Signed on 12/14/2021 04:29 PM - 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: 178DATE:
12/14/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Donna TaconiTIME COMPLETED:
04:40 PM
NARRATIVE
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On 12/14/2021 at 2:40 PM, Licensing Program Analysts (LPAs), Selina Siao and Samantha Clenista conducted a follow up case management inspection regarding the facility failure to follow mask mandates. The initial visit was conducted on 12/09/2021.

On 12/09/2021, there were a total of 97 children observed inside their classrooms with 48 children unmask. This is a repeat violation of the same regulation section within a 12-month period. $1000 civil penalties is being assess today. Director stated that children not wearing a mask was because their parents had signed the facility's in-house medical exemption form. Director stated that they do not have documentation from a medical professional verifying each child that has a medical exemption as indicated on PIN 21-29. As of today, facility has not provide a list of the children with medical exemption as requested on 12/09/2021.

On 12/09/2021, facility was provided with the latest Provider Information Notice (PIN 21-29-CCP) regarding face covering requirements and guidance for child care providers regarding COVID-19. The PIN is also available on the department's website at: https://www.cdss.ca.gov/Portals/9/CCLD/PINs/2021/CCP/PIN-21-29-CCP.pdf

During today's inspection, there were 178 children in care supervised by 24 staff members. 4 children that were indoor not eating snack or sleeping were observed unmask. Appropriate ratios and capacity were observed. See LIC809D for type A citation issued:

“Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. “ An exit interview was conducted. 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: 12/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2021
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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Document Has Been Signed on 12/14/2021 04:29 PM - 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: 12/14/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
12/15/2021
Section Cited

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Personal Rights-The licensee shall ensure that each child is accorded the following personal rights.. To be accorded safe, healthful.. accomodations.. to meet his/her needs. This requirement is not met as evidence by: Based on LPA's observation on 12/09/2021.
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Facility was not following the mask mandates which states that children 2 years and older are to wear face covering/mask indoors in all child care facilities. On 12/09/2021, 48 out of 97 children were observed to be unmask. Violation observed on 12/09/2021 is a repeat violation, $1000 is being assessed. This poses an immediate health and safety risk to clients 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/14/2021 04:29 PM - 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: 12/14/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
12/20/2021
Section Cited

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Child's Medical Assessments Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. The medical assessment shall provide the following:
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Identification of the child's special problems and needs. This requirement is not met as evidence by that facility representative stated that there are 43 children with mask exemptions but need to obtain a note from a medical professional for their exemption.
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Director will advise parents that without a medical professional
note, the child will have to wear a mask or face covering as they do not meet the exemption criteria.

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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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2021
LIC809 (FAS) - (06/04)
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