The classrooms were toured to ensure adequate social distancing and hand-washing stations. LPA observed sufficient and current resources on hand. Covid-19-related safety and informational posters are visibly posted for parents, children and staff. Per the director, facility staff, parents and children are routinely reminded of proper procedures to ensure safety.

Following the tour, LPA discussed with Director, Nora Camcho, current COVID-19 guidance including but not limited to masking, vaccines, food service, visitors, isolation for illness, and responding to Positives and Outbreaks. Director is aware that mask use is strongly recommended. LPA provided the director with COVID-19 printouts of CDPH guidance and the weblink to the current guidance https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Child-Care-Guidance.aspxLPA also discussed and provided the Director with printouts of Provider Information Notices (PIN) 22-08-CCP, 22-01.1-CCLD, and 22-10-CCP related to current COVID-19 guidance.

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*following stricter guidelines such as masking staff and children (those over 2 years) inside and outside. Director stated she is wanting to ask permission from Infection Control at Rady's so children can be allowed to take off masks outside on the playground. Some children have exemptions from wearing the masks. Mask wearing is being encouraged.

*Cohorts are still kept separate including at playtime and outside

*Facility is requiring a 5-day quarantine for close contacts and they may only return with a negative home test

*For anyone who reports sick - a PCR negative test is required before that person can return

*All staff are vaccinated and boosted (except one staff member is not boosted yet (fully vaccinated) and until she is boosted she is tested twice weekly with a PCR test)

*Kids bring their own lunches but facility provides morning and afternoon snack. There is a small kitchen area. Fara Bowles (admin assistant) prepares the snacks. She washes hands and wears gloves while preparing and distributing snack. Teachers serve the food in the classroom (washing hands and wearing gloves) and keep it in the classroom refrigerator. Each classroom has a refrigerator.

*Parents are allowed to come into the facility but are required to wear a mask. This is a teaching hospital child care facility and sometimes hospital employees come to do observations. They are always accompanied by a staff member and are required to wear masks. Director stated they are re-starting walk-thru tours for hospital employees on a case by case basis. Potential parents go through a screening process and a walk-thru of the facility also on a case by case basis. There are no public tours available at this time.

*The isolation areas for sick children waiting for parents to pick up is the two small office rooms at the front of the facility. A cot can be provided for the child while they wait for pickup. No deficiencies were cited during this inspection.

Exit interview conducted and report was reviewed with the facility representative, Nora Camacho. A notice of site visit was given and must remain posted for 30 days.