376600804-12-15-2020-51-CC-GCUS-BWC34V-20201215165546

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600804
Report Date: 12/15/2020
Date Signed: 12/15/2020 04:56:27 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 PRESCHOOL		FACILITY NUMBER:	376600804
ADMINISTRATOR:	MEGHAN ALLDREDGE		FACILITY TYPE:	850
ADDRESS:	13613 CYNTHIA LANE		TELEPHONE:	(858) 748-8012
CITY:	POWAY	STATE: CA	ZIP CODE:	92064
CAPACITY:	94	CENSUS: 46	DATE:	12/15/2020
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Meghan Alldredge		TIME COMPLETED:	05:00 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	Covid-19 State of Emergency Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced case management inspection via Zoom to follow up on a self reported incident that occurred on 12/01/2020 wherein a four year old child fell off the playground slide and sustained an injury. Upon arrival LPA met with Director Meghan Alldredge and proceeded to tour the facility. There were 46 children present with 5 staff members. Appropriate ratios were observed. Staff members have the required background clearances and are associated to the facility During today’s inspection interviews were conducted with the director, several staff members and the two children involved. On 12/1/2020 at approximately 4:45 p.m. child #1 (C1) was on the slide when child #2 (C2) pushed C1 down the slide. C1 fell backwards down the slide. Halfway down the slide C1 fell off the side of the slide onto the woodchips beneath the slide, landing on his stomach. S1 observed the incident and applied first aid. C1 had a small abrasion on the right wrist. The parents of C1 took him to urgent care the night of the incident and C1 was diagnosed with a fractured wrist. An incident report was written and given to the parent of C1. In addition, the director states that she spoke with both sets of parents about the incident. LPA inspected the area where the incident occurred during this virtual inspection. The slide is manufactured by Little Tykes and is made of plastic. The slide is approximately 4 ft. high. When C1 fell off the slide he was approximately 2.5 ft from the ground. Woodchips are located beneath the structure to provide cushioning. It appears to be age appropriate. At the time of the incident there were 2 teachers with 14 children on the playground. Supervision was in place and ratios were met. The facility responded to the incident appropriately and reported timely. On 12/4/20 the director reviewed playground safety rules with staff and the staff reviewed playground safety rules with the children.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace Curtis	TELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2020

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: 12/15/2020

NARRATIVE

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No deficiencies are cited at this time.

An exit interview was conducted and appeal rights (LIC 9058 1/16) were discussed with Director Meghan Alldredge. A copy of this report as well as a copy of the appeal rights were emailed to the Director at the conclusion of the inspection. The Director will confirm receipt of this report via e-mail and the reply of confirmation will serve as the signature acknowledging these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace Curtis	TELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2020

LIC809 (FAS) - (06/04)

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