376600246-6-9-2022-51-CC-TBLK-CF93R6-20220609182812

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600246
Report Date: 06/09/2022
Date Signed: 06/09/2022 06:28:38 PM

Document Has Been Signed on 06/09/2022 06:28 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:	KLASSIC KIDS DAY CARE - GAGE ELEMENTARY		FACILITY NUMBER:	376600246
ADMINISTRATOR:	LAUREN HALL		FACILITY TYPE:	840
ADDRESS:	6811 BISBY LAKE AVENUE		TELEPHONE:	(619) 460-3750
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92119
CAPACITY:	136	CENSUS: 72	DATE:	06/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Belen Lazo		TIME COMPLETED:	06:26 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	Licensing Program Analyst (LPA), Tyra Block, made an unannounced visit for the purpose of a random annual inspection. LPA met with Belen Lazo. During this visit there were 72 children with 7 staff as follows: Auditorium 2 staff:31 children; Outside 4 staff: 41 children plus site supervisor. Facility was out of ratio. Program operates Mon thru Fri from 6:30 a.m. to 8:30 a.m., after school Mon, Tue, Thu & Fri from 2:10 to 6 p.m. and Wed after school from 12:15 to 6 p.m. Program Director, Kristen Gonzalez stopped by briefly during the inspection. Facility is in the process of closing this location. LPA toured the facility. There was sufficient games and activities available for children to use. All equipment appeared to be in good condition and age-appropriate. No hazards were observed. School bathrooms are used with staff supervision (2 bathrooms used for boys and girls and one staff bathroom). Afternoon snack is provided and snack menu is posted. All additional required items were posted. All toxic or hazardous items are stored where they are inaccessible to children. There is at least one staff present with a current CPR and First Aid certification. Sign in/out sheets were reviewed. A sample of children's records were not available for review as the facility is in the process of closing. Staff personnel records were reviewed for qualifications. LPA discussed ratio, mandated reporter training, and site supervisor qualifications. Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra Block	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

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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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
	VISIT DATE: 06/09/2022

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

For deficiencies cited during today's inspection see 809-D.

Exit interview conducted and report was reviewed with the facility representative, Belen Lazo.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra Block	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/09/2022 06:28 PM - It Cannot Be Edited

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: 06/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above in 5 persons out of 7 did not have proof of completion of mandated reporter trianing which posesd a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/17/2022
	Plan of Correction
1 2 3 4	Kristen Gonzalez stated she will submit proof of certifcation when returning license.

Type B

Section Cited

CCR

101216(g)(2)

Personnel Requirements

(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above 1 person did not have health screening which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/30/2022
	Plan of Correction
1 2 3 4	Site supervisor was made aware. LPA requestes that health screening be completed or explanation for reason it could not be obtained as facility is closing but could possibly reassigned to another facility.

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 Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra Block	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

Page: 4 of 6

Document Has Been Signed on 06/09/2022 06:28 PM - It Cannot Be Edited

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: 06/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101221(b)

Child's Records

(b) Each record shall contain information including, but not limited to, the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above no children's records were availalbe for review, they were packed prior to faciilty closure which posesd a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/09/2022
	Plan of Correction
1 2 3 4	Facility maintains electronic copies of emergency information until closure.

Type B

Section Cited

CCR

101516.5(b)(1)

Teacher-Child Ratio

(b) There shall be a staffing ratio of one teacher and one aide present to every 28 children in attendance. (1) A teacher shall supervise no more than 14 children or with an aide a maximum of 28 children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above there were 2 staff with 31 children which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/17/2022
	Plan of Correction
1 2 3 4	Kristen will submit plan for operating in compliance.

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 Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Tyra Block	TELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

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