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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600412
Report Date: 06/20/2019
Date Signed: 06/20/2019 12:38:07 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:NHA EDUCATIONAL CULTURAL COMPLEX HEAD START & CDCFACILITY NUMBER:
376600412
ADMINISTRATOR:MARTHA SHIELDSFACILITY TYPE:
850
ADDRESS:4343 OCEAN VIEW BLVD.TELEPHONE:
(619) 388-4802
CITY:SAN DIEGOSTATE: CAZIP CODE:
92113
CAPACITY:24CENSUS: 16DATE:
06/20/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Mariana Castelum/DirectorTIME COMPLETED:
12:45 PM
NARRATIVE
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(3) Licensing Program Analyst (LPA) Selina Siao conducted a random inspection. Upon arrival, LPA met with current Director Mariana Gastelum in the new office area located in room 46e and it is connected to the licensed classroom. There was one day are child in the classroom with the Special Education staff and 15 children at the outdoor playground supervised by Teachers Osvaldo Berumen and Maria Christina Evans. Furniture and age appropriate equipment is in good condition. Rooms have adequate heating, lighting, ventilation and drinking water is available for children. Storage cubbies are readily available, and room accommodates class size. Napping equipment consists of mats which are kept inside the classroom closet. There are two toilets and two sinks inside the classroom for the children. Bathrooms are maintained with operational toilets and faucets with appropriate temperature. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. Food is brought to the center from the main office kitchen located off site. There is a sink in the office area to prepare lunch and snacks. Menu is posted. Adequate food is available for meals and snacks. Cleaning supplies are kept out of reach of children. Outdoor play area is a fenced playground and there is no high climbing structure at the playground. Area has a large tarp used for shade. Equipment is age appropriate for the children in care. There is an operational drinking fountain at the playground available for children. LPA reviewed sign in sheets, first aid supplies and reviewed medication policy and storage, all areas are complying. Isolation area is the office area. Personnel and client records were reviewed. All personnel have required criminal record and child abuse index clearances. All staff members have proof of the required immunization and mandated child abuse training certificates available for review. LPA reviewed Emergency Disaster Plan and last fire and earthquake drill was conducted with the children on 06/03/2019.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2019
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 3
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: NHA EDUCATIONAL CULTURAL COMPLEX HEAD START & CDC
FACILITY NUMBER: 376600412
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/20/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/10/2019
Section Cited
CCR
101212(b)
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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).
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Director stated that she will report to the main office who will submit the written plan of correction along with the required change of Director's packet to Licensing Program Analyst by 07/10/2019.
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This requirement is not met as facility failed to report and submit the required documents for current Director Mariana Gastelum since September 2018. This poses a potential health and safety risk to clients in care.


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Type B
07/10/2019
Section Cited
CCR
101212(c)
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The licensee shall notify the Department in writing of his/her intent prior to making any structural changes that reduce the total amount of indoor or outdoor activity space. Such structural changes shall include, but not be limited to, room additions.
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Director stated that she will inform the main office to submit a written plan of correction to licensing along with an application to request for decrease of capacity no later than 07/10/2019.
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This requirement is not met as facility has moved their office into the licensed classroom about two months ago without reporting to licensing and might reduce the licensed capacity. This poses a potential health and safety risk to clients 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: NHA EDUCATIONAL CULTURAL COMPLEX HEAD START & CDC
FACILITY NUMBER: 376600412
VISIT DATE: 06/20/2019
NARRATIVE
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Reporting requirements and AB633 was also reviewed. An updated Personnel Report (LIC 500), Emergency Disaster Plan (LIC 610), Facility's roster and facility sketch were obtained today. Facility has at least one staff member that has a valid EMSA approved CPR/FA when children are in care. Facility has an operating carbon monoxide detector.

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

Director was advised to email childcareadvocatesprogram@dss.ca.gov to request to be on the distribution list to obtain child care updates. LPA spoke with Director about the Megan law website and provided the website information: www.meganslaw.ca.gov.

Refer to the next page LIC 809D for deficiency citation. An exit interview was conducted, and appeal rights were provided. A notice of site visit was provided and to be posted at the facility for 30 days. Failure to keep notice posted will result in a civil penalty of $100.00

SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3