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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 372005150
Report Date: 03/22/2023
Date Signed: 03/22/2023 03:41:29 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/24/2023 and conducted by Evaluator Grace Curtis
COMPLAINT CONTROL NUMBER: 51-CC-20230124093940
FACILITY NAME:PALOMAR COMMUNITY COLLEGE DISTRICT ECE LAB SCHOOLFACILITY NUMBER:
372005150
ADMINISTRATOR:TAMARA HOLTHAUSFACILITY TYPE:
850
ADDRESS:1140 WEST MISSION ROADTELEPHONE:
(760) 744-1150
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:108CENSUS: 77DATE:
03/22/2023
UNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Tamara HolthausTIME COMPLETED:
02:59 PM
ALLEGATION(S):
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Health Related Services: Staff did not notify child's authorized representative immediately when the child becomes ill.
INVESTIGATION FINDINGS:
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On March 22, 2023 at 2:25 p.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced inspection to deliver the findings on the complaint allegation referenced above. Upon arrival LPA met with Director Tamara Holthaus, and toured the facility with Site Supervisor Claribel Zorrilla. There were 77 children present with 15 staff members. Appropriate ratios were observed. Staff members have the required background clearances and are associated to the facility.

The initial complaint investigation was conducted by LPA Curtis on 01/31/23 Throughout the course of investigation, interviews were conducted with the complainant and several employees. Facility records were obtained and reviewed. Based on interviews conducted, on 1/18/23 facility staff failed to immediately notify the parent of a daycare child (C1) that the child was ill and was vomiting consistently in a classroom. The child remained ill in the classroom for approximately 45 minutes before the parent/guardian was notified.

Based on interviews conducted by LPA and a record review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED, California Code of Regulations, Title 22, 101226(a) is being cited on the attached LIC 9099D
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 51-CC-20230124093940
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: PALOMAR COMMUNITY COLLEGE DISTRICT ECE LAB SCHOOL
FACILITY NUMBER: 372005150
VISIT DATE: 03/22/2023
NARRATIVE
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An exit interview was conducted with Site Supervisor Zorrilla. A Notice of Site Visit (LIC9213) and Appeal Rights (LIC9058) were provided to Ms. Zorrilla and her signature on this form acknowledges receipt of these rights. LPA observed Notice of Site Visit being posted. Notice of Site visit must remain posted at the facility for 30 days.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 51-CC-20230124093940
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: PALOMAR COMMUNITY COLLEGE DISTRICT ECE LAB SCHOOL
FACILITY NUMBER: 372005150
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/28/2023
Section Cited
CCR
101226(a)
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101226 Health-Related Services: (a) The licensee shall immediately notify the child's authorized representative if the child becomes ill or sustains an injury more serious than a minor cut or scratch. The licensee shall obtain specific instructions from the authorized representative regarding action to be taken. This requirement was not met as evidenced by:
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Site Supervisor Zorrilla states that she will conduct a staff meeting regarding health related services and injury/illness procedures. Ms. Zorrilla will send LPA a copy of the meeting agenda and staff sign in sheet via email by 4/28/23.
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Based on interviews conducted by LPA, on 1/18/23 the parent/guardian of a daycare child (C1) was not immediately notified that the child was ill & vomiting in a classroom. This poses a potential health and safety risk to the children 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: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3