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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374845136
Report Date: 06/08/2022
Date Signed: 06/08/2022 12:54:00 PM


Document Has Been Signed on 06/08/2022 12:54 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:MAAC LINDA VISTA HEAD STARTFACILITY NUMBER:
374845136
ADMINISTRATOR:JANE FABRIGASFACILITY TYPE:
850
ADDRESS:1587 LINDA VISTA DRIVETELEPHONE:
(760) 744-7995
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:30CENSUS: 7DATE:
06/08/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Jane FabrigasTIME COMPLETED:
01:00 PM
NARRATIVE
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On June 8, 2022 at 10:30 a.m. Licensing Program Analyst, Leilani Curtis, conducted an unannounced inspection to follow up on a self-reported incident that occurred on 5/27/22, wherein a 2-year-old child (C1) was left unattended in classroom #3. LPA met with Director Jane Fabrigas and proceeded to tour the facility. There were 7 children with 2 staff members present. Appropriate ratio/capacity were observed. Staff members have the required background clearances and are associated to the facility.

LPA interviewed staff #1 (S1), staff #2 (S2), staff#3 (S3) and the director. On 5/27/22 there were 7 children with 2 staff members in classroom #3. Proper ratios were in place. At approximately 9:15 a.m. S1 and S2 were transitioning the 7 children from classroom #3 to the playground for outside activities. S1 opened the classroom “half door” and facility door to lead the children outside. S2 followed the group out of the classroom, closing the classroom and facility doors. C1 was left in the classroom unattended with the classroom door closed. S3, the lead teacher of room #2, who was standing near classroom #3 and facility doors saw C1 alone in the classroom crying. S3 immediately picked up C1 and returned him to S2 who was already returning to the classroom to retrieve the child. The director was notified of the incident. According to staff C1 was left unattended in the classroom for a few seconds. The parent of C1 was notified of the incident the same day. The director states that she discussed the incident, proper supervision, and transition methods with the staff members involved the day of the incident and conducted an additional follow-up meeting/training with the staff involved on 5/31/22. The director states that she we conduct further training on supervision and transitions with all staff members.
See LIC809D for cited deficiency.

An exit interview was conducted with the director and appeal rights (LIC 9058 1/16) were discussed. The director’s signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed the director post notice of site visit.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2022
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 06/08/2022 12:54 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: MAAC LINDA VISTA HEAD START
FACILITY NUMBER: 374845136

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/17/2022
Section Cited

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101229(a)(1) Responsibility for Providing Care and Supervision: (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by:
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Based on interviews with S1, S2, S3 and the director, C1 was left unattended in a classroom on 5/27/22 when the other children were transitioning with staff to the playground. This poses a potential health and safety risk to 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: 06/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2022
LIC809 (FAS) - (06/04)
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