372005654-9-16-2022-51-CC-PMAA-CJBTY4-20220916150807

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 372005654
Report Date: 09/16/2022
Date Signed: 09/16/2022 03:08:17 PM

Document Has Been Signed on 09/16/2022 03:08 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:	MOUNT OLIVE LUTHERAN PRESCHOOL		FACILITY NUMBER:	372005654
ADMINISTRATOR:	HEATHER FANGON		FACILITY TYPE:	850
ADDRESS:	14280 POWAY ROAD		TELEPHONE:	(858) 679-8169
CITY:	POWAY	STATE: CA	ZIP CODE:	92064
CAPACITY:	85	CENSUS: 61	DATE:	09/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Heather Fangon		TIME COMPLETED:	03:30 PM

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 9/16/22 at 10:50am, Licensing Program Analyst, Patrick Ma, met with Director Heather Fangon for the purpose of an unannounced annual inspection. There were 61 children present with 12 teachers in 6 rooms. Facility is within ratio and capacity. Program operates M – F from 8:30 – 12pm and offers a “Lunch Bunch” extended program from 12 – 2pm M-F. LPA toured the facility. The rooms were clean, orderly and a comfortable temperature during this visit. Adequate ventilation and heating are available. The furniture, books, games and toys are safe, age-appropriate and in good repair. There is a variety of activities available throughout the day. All required forms were posted. All storage containers and trashes have tight fitting lids and are in good repair. There is a kitchen which is clean and sanitary. Food is stored in covered containers at 45 degrees or less and there is no expired or contaminated food present. Children are requested to bring their own snack and lunches but the school has food and snacks if a child forgets to bring their own. Food has been stored separately from any chemicals or cleaning products. Drinking water is readily available via contact less filling stations on the playground. Hand washing and toileting areas are in a safe, sanitary and operating condition. Medications are kept in backpacks with first aid equipment hanging on the wall by the classroom doors, inaccessible to children. Poisons, disinfectants, cleaning solutions and other items that are dangerous to children have been made inaccessible during inspection. Outdoor play area is fully fenced with sufficient cushioning and adequate shade. Age appropriate playground equipment and outdoor surfaces are in a safe condition with any equipment securely bolted to the ground. There are no bodies of water, firearms or ammunition on the property. The carbon monoxide detector is operational. The facility has a written disaster plan in place that meets regulatory requirement and has been conducting and documenting evacuation drills every six months. The facility does not transport children.

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022

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 09/16/2022 03:08 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: MOUNT OLIVE LUTHERAN PRESCHOOL	FACILITY NUMBER: 372005654
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101238(g)

Buildings and Grounds

(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, adult bathroom and kitchen were unlocked during inspection where cleaning solutions under the sinks and knives in drawers were accessible. On the playground, paint cans were accessible on the floor in the equipment shed. This is an immediate health, safety and personal rights risk to children in care.
	POC Due Date: 09/16/2022
	Plan of Correction
1 2 3 4	During the inspection the bathroom, kitchen, and shed was locked and made inaccessible to children.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/16/2022 03:08 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: MOUNT OLIVE LUTHERAN PRESCHOOL	FACILITY NUMBER: 372005654
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

101700.3(b)(1)

101700.3(b)(1) Written Directives: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. Drinking Fountain_By Restroom registered 12.ppb This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on water testing results and interviews, facility Drinking Fountain_By Restroom (by room 9) tested 12.ppb which is over the Action Level Exceedance level. This poses a potential health, safety or personal rights risk to children in care.
	POC Due Date: 09/16/2022
	Plan of Correction
1 2 3 4	Director stated, the fountain has been restricted from used once the facility learned it had lead exceedance levels by placing “OUT OF ORDER” sign, wrapping outlet in plastic with duct tape, and placing tape over access button. Director stated, they plan to remove the fountain after approval from their church council and Board of Education. All staff have been informed not to use the faucets and restrict children from use. The children have access to water outside by touchless refilling fountains on the playground.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022

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: MOUNT OLIVE LUTHERAN PRESCHOOL	FACILITY NUMBER: 372005654
	VISIT DATE: 09/16/2022

NARRATIVE

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LPA reviewed sign in/out sheets, a sample of personnel records and a sample of children's records. There is at least one staff present with current CPR and First Aid certification. 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.

Children are evaluated upon entry and monitored throughout the day for signs of illness. The isolation area for ill children awaiting pick up is the preschool office. The facility understands that current County requirements do not require but strongly recommend state that all children over the age of 2 and staff regardless of vaccination, should wear masks while indoors. Reporting requirements for positive Covid-19 results in children or staff were discussed to include contact with County Department of Public Health for guidance (619-692-8499) and Licensing (619-767-2248) to report the unusual incident.

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 . Services are/are not in place today

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
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.”

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022

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: MOUNT OLIVE LUTHERAN PRESCHOOL	FACILITY NUMBER: 372005654
	VISIT DATE: 09/16/2022

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process
LPA conducted child care quality management interview with facility representative Heather Fangon.
See LIC 809D for deficiencies cited.

LPA Patrick Ma informed facility representative Heather Fangon that this report dated 9/16/22 documents one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Ma informed the facility representative to provide a copy of this licensing report dated 9/16/22 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the facility representative Heather Fangon. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Patrick Ma	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022

LIC809 (FAS) - (06/04)

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