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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600278
Report Date: 04/14/2022
Date Signed: 04/14/2022 10:06:25 AM


Document Has Been Signed on 04/14/2022 10:06 AM - 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:MAAC GOSNELLFACILITY NUMBER:
376600278
ADMINISTRATOR:CLARIBEL ZORRILLAFACILITY TYPE:
850
ADDRESS:139 GOSNELL WAYTELEPHONE:
(760) 736-3066
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:112CENSUS: 0DATE:
04/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Claribel Zorrilla and Linda HernandezTIME COMPLETED:
09:18 AM
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On April 14, 2022 at 8:35 a.m. Licensing Program Analyst (LPA), Leilani Curtis conducted an unannounced inspection. Upon arrival LPA met with area manager Linda Hernandez and director Claribel Zorrilla and toured the facility. There were no children present. The facility is currently on spring break.

The purpose of today’s inspection is to ensure that the corrections listed on LPA Leilani Curtis’s Case Management report dated 4/7/2022 have been completed. The licensee has requested to use the front patio as a temporary playground while the permanent playground is being remodeled. The construction company has installed hazard fencing around the playground and the facility has installed mesh fencing around the existing playground fence. LPA observed the construction crew working on the playground.

LPA measured the patio on 4/7/22 and the measurements are listed on that report. Today, LPA observed that the licensee has installed a fence 48 inches high to separate the temporary preschool playground from the temporary infant center playground. Umbrella’s have been added to the temporary playground area for shade and tables and activities have been added for the children’s use. The area manager states that once the construction on the playground has been completed the temporary playground will be dismantled. A waiver request has been submitted and is pending approval.

On 4/7/22 there were two staff members working with the children who were fingerprint cleared but not associated to the facility. LPA verified that staff member Manijeh Rahmati was associated to the facility on 4/8/22 and staff member Luz Jimenez was associated to the facility today, 4/14/22.

No deficiencies are cited.

LPA reviewed this report with Area Manager Hernandez and Director Zorrilla and appeal rights (LIC 9058 01/16) were discussed. Ms. Hernandez’s signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed the area manager post notice of site visit.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022
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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