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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600804
Report Date: 02/03/2020
Date Signed: 02/03/2020 04:37:37 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:MY ROOM TO GROW PRESCHOOLFACILITY NUMBER:
376600804
ADMINISTRATOR:MARINA SRAGOVICZFACILITY TYPE:
850
ADDRESS:13613 CYNTHIA LANETELEPHONE:
(858) 748-8012
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:94CENSUS: 73DATE:
02/03/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Marina SragoviczTIME COMPLETED:
04:45 PM
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Licensing Program Analysts, Michael Morales-DeSilvestore and Joelle Redding, made an unannounced visit for the purpose of a 1 year required inspection. During this visit there were 73 children with 8 staff. Facility is within ratio and capacity. Program operates 6:30am to 6:00pm Monday- Friday.

The furniture, books, games and toys are safe, age-appropriate and in good repair. Rooms were a comfortable temperature during this visit. No hazards were noted. Medications are kept in a safe place, inaccessible to children. Bathrooms and handwashing areas are in a safe, sanitary and operating condition. Food service area consists of a kitchen which is clean and sanitary with food protected from contamination and spoilage. No expired food items were noted. Menus were posted and are being stored for a minimum of 30 days. All hazardous items are stored where they are inaccessible to children. The outdoor play area is fenced and has enough cushioning under and around play structures, swings and slides. There is no evidence of rodent or insect activity. The carbon monoxide detector is operational. There is at least one staff present with a current CPR and First Aid certification. Sign in/out sheets were reviewed. LPA observed appropriate supervision in and out of the classroom. A sample of children's records were reviewed for admission’s agreements and staff records for qualifications. SB 792 (staff immunizations) and AB 1207 (Mandated Reporter Training) requirements have been met. 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. Isolation area is the Director's office. Effects of Lead Exposure Handout provided for dissemination to parents/guardians.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestoreTELEPHONE: (619) 767-2208
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020
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: MY ROOM TO GROW PRESCHOOL
FACILITY NUMBER: 376600804
VISIT DATE: 02/03/2020
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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.

Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

No deficiencies are cited/See LIC 809D.

NOTICE OF SITE VISIT WAS POSTED DURING THIS VISIT AND WILL REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestoreTELEPHONE: (619) 767-2208
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020
LIC809 (FAS) - (06/04)
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