376600033-9-17-2019-51-CC-LGAO-BG539N-20190917180326

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600033
Report Date: 09/17/2019
Date Signed: 09/17/2019 06:03:31 PM

COMPREHENSIVE INSPECTION

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:	SAY-KUMEYAAY EXTENDED DAY PROGRAM		FACILITY NUMBER:	376600033
ADMINISTRATOR:	BONE, CHASM		FACILITY TYPE:	840
ADDRESS:	6474 ANTIQUA BLVD.		TELEPHONE:	(858) 627-9412
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92124
CAPACITY:	75	CENSUS: 21	DATE:	09/17/2019
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Director Chasm Bone		TIME COMPLETED:	06:00 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	LPA Luigi Gargaro visited the facility to conduct a comprehensive site inspection. Upon arrival LPA met with facility director, Chasm Bone, and toured the facility. All required notices, forms and license(s) were posted. During today's visit, there were 42 children present. There were 21 children being supervised by director Chasm Bone and teacher Maria Gonzalez in the multipurpose room and 21 children in outdoor play area being supervised by teachers Phyllis Huey, Tom Teague and Julia Vasquez. Room 24 and the library are also approved for the program but were not in use during today's visit. Appropriate care & visual supervision were observed during the visit. Children were observed engaging in curriculum and homework activities in the multipurpose room and physical/play activities in the outdoor area. Furniture and age appropriate equipment is in good condition. Care areas have adequate heating, lighting and ventilation. Bathrooms are adjacent to the multipurpose room and maintained with operational toilets and faucets with appropriate temperature. Hand dryers and toilet paper are available in both restrooms. Bathroom is lighted and has ventilation. Snack menu is posted. Adequate food is available for snacks. Cleaning supplies are kept separate from food. The outdoor play area consists of a blacktop and field area. During outdoor review, analyst found group of eight children on play structure being supervised by staff member Huey with thirteen children engaged in athletic play with staffers Teague and Vazquez in the field area. Equipment is age appropriate. Children have access to facility water fountains for drinking water. LPA reviewed sign in sheets, and first aid supplies these areas are in compliance. Personnel records contain health screenings and children’s records contain emergency information and medical assessments. At least one staff member has current CPR and First Aid certifications. 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. Fire and disaster drills are conducted as required. Facility has an operational carbon monoxide detector.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019

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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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: SAY-KUMEYAAY EXTENDED DAY PROGRAM	FACILITY NUMBER: 376600033
	VISIT DATE: 09/17/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The program currently has two children who have medication for emergency use on site. Analyst reviewed the medication policy, documentation and expiration dates for them and found all to be in order. A plan for IMS was submitted to the department and approved on 02/12/16. 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. LPA and director discussed California Megan's Law and he provided director with the website address: www.meganslaw.ca.gov for her to review information regarding her facility on a regular basis.

No deficiencies are cited as the facility appeared to be in substantial compliance during today’s visit. Director was provided with Notice Of Site Visit to post in notice area for 30 days.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019

LIC809 (FAS) - (06/04)

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