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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600162
Report Date: 07/21/2020
Date Signed: 07/21/2020 04:48:32 PM

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:MISSION NAZARENE PRESCHOOLFACILITY NUMBER:
376600162
ADMINISTRATOR:ANGELA SIROTAFACILITY TYPE:
850
ADDRESS:4750 MISSION GORGE PLACETELEPHONE:
(619) 287-4900
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY:114CENSUS: DATE:
07/21/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:03 PM
MET WITH:Angela SirotaTIME COMPLETED:
04:20 PM
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On 7/21/2020, Licensing Program Analyst (LPA) Tyra Block conducted an unannounced Case Management tele-inspection via Facetime due to COVID-19. The purpose of the visit was to follow-up on the COVID-19 case reported on Friday, 7/17/20.

LPA Block met with Director, Angela Sirota. Present at the facility was 17 teachers and 54 children, 15 children were under the age of 2. Child #1 is anticipated to return to care on Thursday, 7/23/20 pending negative test results. No other person at the facility or associated with the facility has tested positive or is waiting for results. The Director states that current Child Care Guidance is being followed to keep staff and children safe, including daily temperature checks and symptom screening of staff, parents, and children and cleaning and disinfecting frequently throughout the day.

LPA toured the facility and requested a copy of the Children's Roster be resent due to not receiving it. LPA will email COVID-19 resources, including posters for Licensee to post throughout the facility.

No deficiencies are cited.

An exit interview was conducted with the Licensee and she was provided a copy of the Appeal Rights (LIC9058), this report, and the Notice of Site Visit via email. Licensee will acknowledge receipt of these items in lieu of a signature by sending an email confirmation. Notice of Site Visit will remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Tyra BlockTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2020
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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