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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600808
Report Date: 08/11/2021
Date Signed: 08/11/2021 05:09:05 PM

Document Has Been Signed on 08/11/2021 05:09 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:CENTRAL STATE PRESCHOOLFACILITY NUMBER:
376600808
ADMINISTRATOR:ELIZABETH CASTILLO-DUVALFACILITY TYPE:
850
ADDRESS:4063 POLK AVENUETELEPHONE:
(619) 344-6100
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 48TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/11/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Elizabeth Castillo-DuvalTIME COMPLETED:
12:50 PM
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On 08/11/21 at 9:40 AM, Licensing Program Analysts (LPAs), JoAnn Legaspi and Rajani Goudreau conducted an unannounced Case Management inspection. Upon arrival, LPAs met with Principal/Director, Elizabeth Castillo-Duval and disclosed the inspection’s purpose. The Director provided LPAs with facility entry. LPAs proceeded to tour the facility indoors and outdoors. The facility is requesting to replace classrooms 53 and 54 with classrooms 15 and 17, to serve children ages 2 years to 5 years. There were no children in care during the inspection because the school was on summer break, but the program will resume on 08/30/2021. The facility operates weekdays from 8 AM to 2 PM on the campus of Central Elementary School, during the traditional school year. This facility is a Title 5 Program.

The following classrooms were inspected and measured during the inspection:

Classroom #15 measured a total of 890.37 square feet.

Classroom #17 measured a total of 888.15 square feet.

The indoor space measured a total of 1,778.52 square feet which is sufficient to accommodate 50 children at one time. However, facility is only requesting a capacity of 48 children. The classrooms are equipped with appropriate furniture and napping mats including tables, chairs, cubbies, bookshelves, and other materials for the children to utilize. A carbon monoxide detector is located in both rooms 15 and 17. The facility also has first aid kits that maintains required supplies. Disinfectants, cleaning solutions, and other hazardous substances were observed out of children’s access during this inspection. Required postings are posted in the classrooms. Children will utilize a shared girls’ restroom with the elementary school children. See LIC809-C continuation page...
Tulam Vu
JoAnn R Legaspi
DATE: 08/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2021
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: CENTRAL STATE PRESCHOOL
FACILITY NUMBER: 376600808
VISIT DATE: 08/11/2021
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 The restroom is located in the west wing of the school near rooms 28 and 29. The restroom contains 11 toilets and 3 sinks. In addition, there is one sink available for the children's use in each of the classrooms 15 and 17. There are sufficient sinks and toilets based on the requested capacity of 48 children. The restroom waiver request and plan of operation was obtained at the time of inspection because the restroom is shared with the elementary school children.

The outdoor playground is located near Room 15. The outdoor playground area was inspected and measured a total of 12,430.65 square feet, which is sufficient for 165 children. The play equipment is suitable for ages 2 years to 5 years old. The surface of the outdoor activity space is maintained, in a safe condition and free of hazards. Areas around high climbing equipment, swings and slides have cushioning material, such as padded rubber matting to absorb falls. There is shade in the outdoor playground by the use of trees. The Director and LPAs discussed proper supervision and placement of staff on the playground to ensure the supervision and the safety of children. Drinking water is available both indoors and outdoors. Drinking water on the playground and classroom is made accessible to children via individual water bottles.

The playground is shared with the elementary school children on a scheduled basis. The playground waiver request and schedules were obtained at time of inspection

A fire clearance for 48 preschool children, ages 2 through 5 years old, in rooms 15 and 17, was granted on July 20, 2021.

No deficiencies issued throughout today's inspection. Due to changes in the prior restroom and playground waivers, amended waivers will need to be submitted. Once the waivers have been reviewed and approved, a license will be issued for children ages 2 years to 5 years in Rooms 15 and 17.

LPAs provided staff with the Notice of Site Visit – LIC 9213, which is to be posted for thirty (30) days. An exit interview was conducted with Director Castillo-Duval, who was provided a copy of this report and their Licensee Rights (LIC 9058 1/16). Their signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021
LIC809 (FAS) - (06/04)
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