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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105014
Report Date: 04/09/2021
Date Signed: 04/09/2021 01:08:50 PM

Document Has Been Signed on 04/09/2021 01:08 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:NHA - KAREN D. LOVE HEAD STARTFACILITY NUMBER:
376105014
ADMINISTRATOR:LORENA AGRAZFACILITY TYPE:
850
ADDRESS:2230 EAST JEWETT STREETTELEPHONE:
(858) 433-6505
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY: 59TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/09/2021
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Lorena AgrazTIME COMPLETED:
01:15 PM
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On April 9, 2021 at 12:00 PM. Licensing Program Analyst (LPA) Adrian Mangina conducted an unannounced Case Management Inspection via Facetime in reference to three reported cases of Covid-19. The cases include one staff who teaches virtually, one staff in room 5A and one student in room 4B, who all tested positive for COVID-19 on 03/25/21 during regularly scheduled biweekly school wide testing. LPA met with Director Lorena Agraz and proceeded to tour the facility. Present today were 0 children and 2 staff members. Appropriate ratios were observed. All staff members have the required background clearances and are associated to the facility.

Director stated that there are 5 classrooms at the school. Classrooms 1, 2, 3 are closed due to covid. The center capacity is 82 children when fully opened. The two open classrooms are classroom 5 with 2 cohorts A and B. Cohort 5A has three teachers and seven children and includes days Monday and Tuesday from 7:30 AM to 2:00 PM. Cohort 5B has three different teachers than cohort A and includes nine children and operates Thursday and Friday from 7:30 AM to 2:00 PM. Classroom 4 also has two cohorts 4A operates Monday and Tuesday from 7:30 AM to 2:00 PM and includes three teachers and five students. Classroom 4B operates Thursday and Friday from 7:30 AM to 2:00 PM and includes three different teachers and five children.

The affected individuals were tested 3/25/21 during regularly scheduled testing that is provided by Rady's Children's Hospital in partnership with NHA. None of the affected individuals was symptomatic when tested. There is no commingling of classrooms 4 and 5, except that they share a bathroom. The only contact they have is when the children from each classroom use the bathroom together. The teacher lounge is closed and each classroom has its own designated playground separated by a fence.

(continued on LIC809 page 2)
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2021
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: NHA - KAREN D. LOVE HEAD START
FACILITY NUMBER: 376105014
VISIT DATE: 04/09/2021
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The Director states that the Department of Public Health, staff and all parents with children enrolled at this facility were contacted on 3/26/21 by telephone and email. Director stated that Associate Vice President of Human Resources contacted the health department on 3/26/21 and was told to close both classrooms until 4/12/21.

Director stated that the entire school was tested again on 4/8/21 to be sure that there are no other cases prior to reopening. Thise test results are pending.

Director stated that she and another staff are on premises today to install a "Zono" machine which is used for sanitizing all types of items, such as toys, cots and furniture. The facility also has a UV sanitizer wand which is used to sanitize small objects. The facility is cleaned three times daily by janitors and each classroom is cleaned three times daily by teachers. The facility was deep cleaned on 4/8/21.

LPA Mangina received LIC624 Unusual Incident report from Director on 3/30/21. LPA Mangina advised Director to send a copy of the facility roster.. LPA Mangina will continue to follow up with Director Agraz on the facility’s situation. Covid-19 guidelines visit was conducted by LPA Adrian Mangina on 2/11/21. COVID-19 guidance was reviewed with Director Agraz and she was provided resources via e-mail: COVID-19 Guidance, CAL-OSHA guidance, Childcare Decision Tree, Covid-19 Self-Assessment, posters to display, list of websites for more information and a link to a mask video for children.

No deficiencies were observed.

An exit interview was conducted with Licensee. A Notice of Site Visit (LIC9213) and Appeal Rights (LIC9058) will be sent along with the report (LIC809) via e-mail to the Licensee. Licensee will confirm receipt of these reports via e-mail and the reply of confirmation will serve as the signature acknowledging these rights. The Notice of Site Visit (LIC9213) must remain posted for 30 days.
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2021
LIC809 (FAS) - (06/04)
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