376600461-2-1-2023-20-CC-LGAO-CNN2G5-20230201162235

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600461
Report Date: 02/01/2023
Date Signed: 02/01/2023 04:22:46 PM

Document Has Been Signed on 02/01/2023 04:22 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:	WALDORF SCHOOL OF SAN DIEGO		FACILITY NUMBER:	376600461
ADMINISTRATOR:	LAURA FORD		FACILITY TYPE:	850
ADDRESS:	3547 ALTADENA AVENUE		TELEPHONE:	(619) 280-8016
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY:	83	CENSUS: 60	DATE:	02/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Director Laura Ford		TIME COMPLETED:	04:15 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	On 02/01/23, at 10:00AM, Licensing Program Analyst (LPA) Luigi Gargaro, conducted an unannounced annual inspection visit and met with facility director, Laura Ford. LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors. The preschool program consists of a full day session which runs from 8:00AM-5:00PM and operates in conjunction with the school year calendar of its co-located elementary school program. Days of operation are Monday-Friday. There are currently five classrooms, rooms 2, 3, 4, 5 and 6, in operation. The following ratios were observed: Classroom 2 (serves children ages 4 1/2 through kindergarten and is also known as the Lilac Kindergarten Room): There were 9 children present with 2 staff members Myra Sanderlin and Stephanie Quintetro; Classroom 3 (serves children ages 4 1/2 through kindergarten and is also known as the Rosemary Kindergarten room); There were 13 children present under the supervision of staff members Laura Ford, Isabelle Adame and, alternatively, Elizabeth Heald; Classroom 4 (serves children ages 4 1/2 through kindergarten and is also known as the Periwinkle Kindergarten room); There were 17 children present under the supervision of staff members Aminta Penman and Julia Antti; Classroom 5 (serves children ages 3 - 4 1/2 years old and is also known as the Sunflower Nursery room): There were 12 children present under the supervision of staff members Sheila Salmeron and Leticia Ortega; and Classroom 6 (serves children 3 - 4 1/2 years old and is also known as the Sweet Pea Nursery room which is a three day program): There were 9 children present under the supervision of staff members Christine Klincewicz and Terri Anti. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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: WALDORF SCHOOL OF SAN DIEGO	FACILITY NUMBER: 376600461
	VISIT DATE: 02/01/2023

NARRATIVE

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Children bring their lunches from home. The facility provides snacks. All food is protected against contamination and any contaminated food is discarded immediately. Drinking water is available both indoors and outdoors. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

A review of staff records on this date indicates that some facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained. Staff members currently have CPR and Pediatric First Aid certifications from an EMSA or American Heart Association certified training provider as required by regulations

The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. All children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training. Snack menus are posted for the school term where an authorized representative can view them.

This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. However, an IMS plan is required to be submitted to the licensing office if they provide any of these services and the facility currently does not have an official one on file. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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: WALDORF SCHOOL OF SAN DIEGO	FACILITY NUMBER: 376600461
	VISIT DATE: 02/01/2023

NARRATIVE

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During today's visit analyst also inspected an additional playground area, the Lilac Yard, that the school would like to add to its approved outdoor area. Analyst inspected the area and took photos of it to review with his manager prior to granting final approval.

LPA and Director Ford discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, California Megan’s Law (www.meganslaw.ca.gov), Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficienc(y)ies is/are being cited: (see next page, 809 D) An exit interview was conducted with Director Ford and she was provided a copy of the facility's appeal rights (LIC 9058)

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/01/2023 04:22 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: WALDORF SCHOOL OF SAN DIEGO	FACILITY NUMBER: 376600461
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Request Denied

Type A

Section Cited

CCR

101170(e)(1)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or 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 as two staff members did not have a criminal record clearance on the facility's associated listing which poses an immediate health, safety or personal rights risk to children in care.
	POC Due Date: 02/02/2023
	Plan of Correction
1 2 3 4	Director stated that the two staff members have been printed and have received clearances and will either locate them in the Guardian system and have them transferred or will have them reprinted immediately and advise analyst of their status by 02/02/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/01/2023 04:22 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: WALDORF SCHOOL OF SAN DIEGO	FACILITY NUMBER: 376600461
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. 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 as all facility staff currently only have CPR/First Aid certifications through non EMSA certified provider Do It Right CPR rather than a regulation required EMSA certified provider which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 03/01/2023
	Plan of Correction
1 2 3 4	Prior to end of visit, Director Ford did provide evidence of subsequent eight hour training the staff took through the approved trainer the American Heart Association correcting the deficiency.

Section Cited

Child's Records


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

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