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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005809
Report Date: 04/15/2022
Date Signed: 04/15/2022 12:58:21 PM


Document Has Been Signed on 04/15/2022 12:58 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:CHILDREN'S PRESCHOOL LEARNING CTR-SCHOOL AGE PROG.FACILITY NUMBER:
372005809
ADMINISTRATOR:RENEE ERICKSONFACILITY TYPE:
840
ADDRESS:13168 POWAY ROADTELEPHONE:
(858) 748-5519
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:14CENSUS: 7DATE:
04/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Renee EricksonTIME COMPLETED:
01:00 PM
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On 4/15/22 at 11:00 AM, Licensing Program Analyst (LPA) Keturah Lane visited the facility to conduct an annual inspection. Upon arrival LPA met with Director Renee Erickson and proceeded to tour the facility. During today's inspection, there were 7 children with staff member Sapna Keshav. Facility is an open space separated by bookshelves and half-walls and also has a preschool and infant license. The school age area is the rear left corner of the facility (as you walk in). Appropriate ratios and capacity were observed. Appropriate care & visual supervision were also observed during the inspection while children were working on activities at tables.
Furniture and age appropriate equipment is in good condition. Rooms have adequate heating, lighting, ventilation. Floors appear to be clean and safe. Drinking water is readily accessible. Bathrooms are maintained with operational toilets and faucets with appropriate temperature. Bathrooms are not used simultaneously by children of both sexes and provide individual privacy. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. Children bring their own lunches and snacks are provided for the children. A school lunch is available for children who don’t bring one. Food service area consists of a small kitchen/break which is clean and free of hazards. Menu is posted. Adequate food is available for meals and snacks. Cleaning supplies are kept separate from food and are inaccessible to children. Storage containers for solid waste have tight-fitting covers and are kept in good repair. Storage areas for poisons are locked. Director stated there are no firearms or other weapons on the premises. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 F or less. The facility appears to be free of insects and rodents. There is an operational carbon monoxide detector at the facility.
Outdoor play area is a fenced playground with sufficient material for cushioning. There is a climbing structure only used by the school age children at the far end of the playground. LPA observed staff supervising on the playground and preschool children were not allowed near the school-age structure. School-age children use the playground at different times than preschoolers. There are no bodies of water or weapons at this facility. Climbing structures, swings and slides are securely fixed to the ground. Area has trees and canopies used for shade. Equipment is age appropriate. Area has drinking water readily accessible and grounds are free of debris or potential hazards. (continued on LIC809-C)...
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:
DATE: 04/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/15/2022
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 2


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: CHILDREN'S PRESCHOOL LEARNING CTR-SCHOOL AGE PROG.
FACILITY NUMBER: 372005809
VISIT DATE: 04/15/2022
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LPA reviewed medication storage. Personnel records contain health screening documentation and at least one staff member has current CPR and First Aid certifications. Staff member has required immunizations. Each personnel record contains documentation of educational background and training. Sign ins were reviewed. Children’s records contain admission agreements and medical assessment. LPA requested updated forms for facility file: LIC500 personnel report, LIC610 Emergency Disaster Plan and updated admissions policies.
A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. 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.
Incidental Medical Services (IMS) was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

No deficiencies were cited at this inspection.
Exit interview conducted and report was reviewed facility with representative Renee Erickson. A notice of site visit was given and must remain posted for 30 days.

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.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022
LIC809 (FAS) - (06/04)
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