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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600680
Report Date: 05/17/2023
Date Signed: 05/17/2023 02:00:06 PM

Document Has Been Signed on 05/17/2023 02:00 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:ST. MARY'S PRESCHOOLFACILITY NUMBER:
376600680
ADMINISTRATOR:AMANDA HARRIFFFACILITY TYPE:
850
ADDRESS:130 E. 13TH AVENUETELEPHONE:
(760) 745-1611
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY: 77TOTAL ENROLLED CHILDREN: 77CENSUS: DATE:
05/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Amanda HarriffTIME COMPLETED:
02:15 PM
NARRATIVE
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On May 5, 2023 at 9:45 AM Licensing Program Analyst (LPA), Courtnee Peebles conducted an annual inspection as part of a compliance review. A tour of the inside and outside of the facility was granted and the following was observed and/or noted:

· The following items were posted and updated where necessary:
- License
- Emergency Disaster Plan (LIC610) and Earthquake Preparedness Checklist (LIC9148)
- Parent’s Rights Poster (PUB393)
- Personal Rights (LIC613A)
- Child Car Seat Law
- All food/snacks are provided by the parents
· The facility is operating within the limits as stated on the license.
· Ratios are being met during this inspection this facility has three active classrooms with a total of 28 children and five staff
· Classrooms are adequately equipped with age and size appropriate furniture and equipment and free of hazards
· There are no weapons present at the facility as stated by Amanda Harriff
· There are no accessible bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Drinking water is provided in the indoor activity space and in the outdoor activity space by public filtered drinking fountains around the facility.
· There are currently no children in need of medication
· Hazardous items are stored where inaccessible to children which include: Disinfectants, cleaning solutions and other items that are dangerous in locked cabinets in each classroom
· All floors were observed to be clean and safe
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023
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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Document Has Been Signed on 05/17/2023 02:00 PM - It Cannot Be Edited


Created By: Courtnee Peebles On 05/17/2023 at 01:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ST. MARY'S PRESCHOOL
FACILITY NUMBER: 376600680

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/17/2023

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
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Based on record review and interview, the licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/31/2023
Plan of Correction
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The director Amanda Harriff stated she will have S3 retake First aid/CPR training this week and will provide proof to LPA via email showing the completion if the training by 05/31/2023
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Pauline Beschorner
LICENSING EVALUATOR NAME:Courtnee Peebles
LICENSING EVALUATOR SIGNATURE:
DATE: 05/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/17/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/17/2023 02:00 PM - It Cannot Be Edited


Created By: Courtnee Peebles On 05/17/2023 at 01:21 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ST. MARY'S PRESCHOOL
FACILITY NUMBER: 376600680

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/17/2023

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
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Based on record review, the licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/31/2023
Plan of Correction
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The director Amanda Harriff stated she will have S4 take the mandated reporter training this week and will provide proof of the completion of the training by S4 via email by 05/31/2023
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/31/2023
Plan of Correction
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The director Amanda Harriff stated she will have S4 take the mandated reporter training this week and will provide proof of the completion of the training by S4 via email by 05/31/2023
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:Pauline Beschorner
LICENSING EVALUATOR NAME:Courtnee Peebles
LICENSING EVALUATOR SIGNATURE:
DATE: 05/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/17/2023


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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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: ST. MARY'S PRESCHOOL
FACILITY NUMBER: 376600680
VISIT DATE: 05/17/2023
NARRATIVE
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·Bathrooms were observed to be safe, sanitary and in operating condition
· Playgrounds are enclosed by appropriate fences and free of hazards
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· All storage containers for solid waste were observed to have tight-fitting covers that are kept on, and in good repair
· Sign in/Sign out record was reviewed and meets regulation requirements
· Disaster drills are conducted at least every six months – last drill conducted on 03/14/2023

A review of staff and children's records were conducted as part of this evaluation.
· Children’s records were found to be complete during this inspection.
· Staff records review indicates that all staff present meet minimum qualifications for the position for which they were hired. Staff records are not complete During record review Staff (S4) did not have current Mandated reporter training. This poses a potential health, safety or personal rights risk to persons in care. A citation will be issued.
During interview LPA asked the director who her opening staff is daily. The director stated Staff (S3) is the opener. During record review LPA observed S3 to be missing a current First Aid/CPR training. This poses a potential health, safety or personal rights risk to persons in care. A citation will be issued.
During record review LPA observed Staff (S4) to not have TB testing results readily available in the file. This poses a potential health, safety or personal rights risk to persons in care. A citation will be issued.
· A staff member is present with current Pediatric CPR/First Aid which expires on 11/24/2023
· Opening and closing staff member’s CPR/First Aid expires on 11/17/2023
· Director completed Health and Safety Training
· A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

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
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
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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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: ST. MARY'S PRESCHOOL
FACILITY NUMBER: 376600680
VISIT DATE: 05/17/2023
NARRATIVE
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The following items were discussed with the Licensee/Director during inspection:
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall
· The Licensee was informed of their reporting requirements and provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov

The director 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.

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.



The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200

The licensee/director was asked to update the following documents, if applicable, and submit to licensing within 30 days:
1. LIC 500 Personnel Report
2. LIC 610 Emergency & Disaster Plan
3. Parent Handbook/ Program Curriculum/Admission policies and procedures/ fee schedule (only if changes have been made or file copy is more than 2 years old)
4. LIC 309 Administrative Organization (only if changes have been made or file copy is more than 2 years old)
5. LIC 308 Designation of Administrative Responsibility (only if changes have been made& current designation is on file)
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
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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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: ST. MARY'S PRESCHOOL
FACILITY NUMBER: 376600680
VISIT DATE: 05/17/2023
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See LIC809-D for cited deficiencies

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/process.

An exit interview was conducted, and this report was reviewed with the director Amanda Harriff. Appeal rights were discussed and provided during the exit interview.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Courtnee Peebles
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
LIC809 (FAS) - (06/04)
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