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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600768
Report Date: 04/20/2023
Date Signed: 04/20/2023 02:14:29 PM


Document Has Been Signed on 04/20/2023 02:14 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:CONGREGATION BETH ISRAEL/SID RUBIN PRESCHOOLFACILITY NUMBER:
376600768
ADMINISTRATOR:CATHY GOLDBERGFACILITY TYPE:
850
ADDRESS:9001 TOWNE CENTRE DRIVETELEPHONE:
(858) 900-2530
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY:105CENSUS: 75DATE:
04/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director Cathy GoldbergTIME COMPLETED:
12:30 PM
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On 4/20/2023 at 9:15 a.m., Licensing Program Analysts (LPAs), Joelle Redding and Gerald Poindexter, met with Director Cathy Goldberg for the purpose of an unannounced annual inspection. There were 75 children present with 15 staff in Rooms 104 (Toddler Option), Rooms 200, 202, 204-206. Rooms 101 and 103 were not currently in use. Facility is within ratio and capacity.

LPA toured the facility. The rooms were clean, orderly and a comfortable temperature during this visit. Adequate ventilation and heating are available. The furniture, books, games and toys are safe, age-appropriate and in good repair. There are a variety of activities available throughout the day. All required forms were posted. All storage containers and trashes containing solid waste have tight fitting lids and are in good repair. AM/PM snacks are provided and snacks (toddlers bring all their own food) are stored in the classroom's adjoining kitchens. The kitchens are clean and sanitary with food is stored in covered containers at 45 degrees or less and there is no expired or contaminated food present. Staff preparing food are using proper personal hygiene and food service practices. The food meets the nutritional requirements per regulation and is of good quality and proper quantity. The snack menu is posted, changes are recorded, and menus are stored for 30 days. Food has been stored separately from any chemicals or cleaning products. Drinking water is readily available. Napping equipment is sufficient for each child, bedding is stored separately, and mats are disinfected after use. Facility has ensured that there is adequate space between mats for easy passage and they are not blocking entrances or exits. Hand washing and toileting areas are in a safe, sanitary and operating condition. Any waste water used to clean is being discarded after use. Medications are kept in the office or in the classroom, inaccessible to children. Poisons, disinfectants, cleaning solutions and other items that are dangerous to children have been made inaccessible. There is no evidence of rodent or insect activity. Outdoor play areas are fully fenced with sufficient cushioning and adequate shade. Age appropriate playground equipment and outdoor surfaces are in a safe condition with any equipment securely bolted to the ground. Portable water is used outdoors. There are no bodies of water,
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2023
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: CONGREGATION BETH ISRAEL/SID RUBIN PRESCHOOL
FACILITY NUMBER: 376600768
VISIT DATE: 04/20/2023
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 firearms or ammunition on the property. The carbon monoxide detector is operational. The facility has a written disaster plan in place that meets regulatory requirement and has been conducting and documenting evacuation drills every six months. The facility does not transport children.

LPA reviewed sign in/out sheets (ProCare - electronic), a sample of personnel records and a sample of children's records. There is at least one staff present with current CPR and First Aid certification. Facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com.



LPA discussed the safe sleep regulations and the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Children are evaluated upon entry and monitored throughout the day for signs of illness. The isolation area for ill children awaiting pick up is the Director's office. Reporting requirements for positive Covid-19 results in children or staff were discussed to include contact with County Department of Public Health for guidance (619-692-8499) and Licensing (619-767-2248) to report the unusual incident for three or more cases.



This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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 . Services are not in place today.

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
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
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: CONGREGATION BETH ISRAEL/SID RUBIN PRESCHOOL
FACILITY NUMBER: 376600768
VISIT DATE: 04/20/2023
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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.

Licensee is signed up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov.


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

LPA conducted child care quality management interview with Director Cathy Goldberg. Exit interview conducted and report was reviewed with the Director.

See LIC 809D for Type B deficiency. Updated LIC 500 and Parent Handbook were requested. LIC 610 was provided today.

NOTICE OF SITE VISIT WAS GIVEN AND WILL REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 04/20/2023 02:14 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: CONGREGATION BETH ISRAEL/SID RUBIN PRESCHOOL
FACILITY NUMBER: 376600768

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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 that Staff #1 and 2 did not have the Measles vaccination information on file and Staff #3 was missing Measles and Pertussis information which poses a potential health, safety or personal rights risk to children in care.
POC Due Date: 05/05/2023
Plan of Correction
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Director states that proof of immunization will be on file for all staff by the plan of correction date of 5/5/2023, and proof will be emailed to LPA as verification of correction.
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: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2023
LIC809 (FAS) - (06/04)
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