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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600246
Report Date: 01/10/2022
Date Signed: 01/10/2022 06:05:46 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:KLASSIC KIDS DAY CARE - GAGE ELEMENTARYFACILITY NUMBER:
376600246
ADMINISTRATOR:LAUREN HALLFACILITY TYPE:
840
ADDRESS:6811 BISBY LAKE AVENUETELEPHONE:
(619) 460-3750
CITY:SAN DIEGOSTATE: CAZIP CODE:
92119
CAPACITY:136CENSUS: 45DATE:
01/10/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
05:14 PM
MET WITH:TIME COMPLETED:
06:05 PM
NARRATIVE
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On 1/10/22, Licensing Program Analyst (LPA), Tyra Block, conducted an unannounced case management visit to discuss deficiencies found during complaint investigation. Present at the facility was 5 staff and 45 children when LPA first arrived at facility. All staff had appropriate criminal record clearance.

Technical assistance was also provided to discuss best practices regarding sign-in/out procedures.

See LIC 809-D for type B deficiencies cited.

An exit interview was conducted with facility representative , Kristen Gonzalez. The Notice of Site Visit was provided. It must be posted for 30 days.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra BlockTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022
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: KLASSIC KIDS DAY CARE - GAGE ELEMENTARY
FACILITY NUMBER: 376600246
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/21/2022
Section Cited

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101529.1(b)-Sign In and Sign Out: Center staff shall sign in a school-age child who arrives at the center on his/her own. This requirement was not met as evidenced by:
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Based on interviews conducted with staff, children, and parents children have not been signed in and not accounted for on more than one occasion. This poses a potential health and safety risk to chidlren in care.
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Type B
01/21/2022
Section Cited

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101212(b)- Reporting Requirements: The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement was not met as evidenced by:
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Based on interview and documentation the required documentation has not been submitted within the appropriate time frame. This poses a potential health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra BlockTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2022
LIC809 (FAS) - (06/04)
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