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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105014
Report Date: 05/06/2022
Date Signed: 05/06/2022 01:18:05 PM

Document Has Been Signed on 05/06/2022 01:18 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: 77TOTAL ENROLLED CHILDREN: 77CENSUS: 40DATE:
05/06/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Lorena AgrazTIME COMPLETED:
01:30 PM
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On 05/062022 at 11:50am, Licensing Program Analyst (LPA) Samantha Clenista conducted an unannounced case management site inspection to follow up on a self-reported incident that occurred on 03/04/2022.

Upon arrival, LPA met with Center Director, Lorena Agraz, and proceeded to tour the facility. There were a total of 40 children with a total of 11 staff members. Children were observed either laying on their cots or getting ready for nap time. Appropriate ratio, capacity and supervision was observed. All required notices, forms and licenses were posted.

On 03/07/2022, facility reported an incident that occurred on 03/04/2022, regarding a possibly personal rights violation. LPA conducted interviews during inspection with staff, alleged victim and alleged victim's parent regarding the incident. LPA obtained updated children's roster. Based on information gathered, there is not sufficient evidence to confirm that a personal rights violation occurred. LPA reminded Director that no corporal punishment is allowed. LPA provided Child Care Licensing website and resources for providers dealing with behavioral issues.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No citations issued regarding this incident. Exit interview was conducted with Director. LPA provided a copy of LIC 9213, “Notice of Site Visit,” and observed director posting notice during visit. LIC9213 shall remain posted for 30 consecutive days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE: DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2022
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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