376600839-10-12-2022-51-CC-NDIZ-CK5PWG-20221012114042

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600839
Report Date: 10/12/2022
Date Signed: 10/12/2022 11:40:56 AM

Document Has Been Signed on 10/12/2022 11:40 AM - 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:	NHA - WALKER HEAD START		FACILITY NUMBER:	376600839
ADMINISTRATOR:	HOLLAND, BRENDA		FACILITY TYPE:	850
ADDRESS:	9245 HILLERY DRIVE		TELEPHONE:	(858) 653-3671
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92126
CAPACITY: 36	TOTAL ENROLLED CHILDREN: 48	CENSUS: 10	DATE:	10/12/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Brenda Holland		TIME COMPLETED:	11:50 AM

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	On 10/12/2022 @ 9:30AM, LPA Nancy Diaz conducted an unannounced inspection. LPA met with Brenda Holland, Site Supervisor. Observed present today were 10 children. A tour of the facility was conducted. There are 2 classrooms utilized by children. There were 5 children in Room 1A with staff Neng Lao, Eman Aldameri, Chanmany Sisolvong & Phuong Nguyen. There were 5 children in the Toddler group with staff Lilian Tunda & Yen Szeto. Program operates Monday-Friday; 7AM to 4PM. 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 clearances or exemptions. The licensee has not exceeded the conditions, limitations and capacity specified on the license. The majority of staff at this site are trained in CPR and Pediatric First aid - Ms. Brenda Holland, Eman Aldameri, Liliane Tunda and Maryam Shahbaz. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Medications are kept in a safe place, inaccessible to children. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All toilets, handwashing facilities are in safe and sanitary operating condition. All floors are clean and safe. The child care center was observed to be clean, safe, and sanitary to ensure the safety and well-being of children, employees and visitors. Facility maintains a carbon monoxide detector that meet the standards established in Chapter 8 of Part 2 of Division 12. Playground equipment was observed to be in safe condition, free of sharp, loose or pointed parts. A portion of the surface of the outdoor activity space was observed to be in disrepair and will need to be re-surfaced. Ms. Holland installed a yellow tape and are advising staff and children not to use the area until repair is completed.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

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 10/12/2022 11:40 AM - It Cannot Be Edited

Created By: Nancy Diaz On 10/12/2022 at 11:11 AM

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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: NHA - WALKER HEAD START	FACILITY NUMBER: 376600839
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(a)

Buildings and Grounds

(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. LPA observed several cracks on children's play surface that poses a tripping hazard. Ms. Holland installed a yellow tape and will remind staff and children not to use the area until repair is completed.
	POC Due Date: 10/19/2022
	Plan of Correction
1 2 3 4	Ms. Holland shall submit a plan of action by 10/19/2022 to show the plan to repair the play surface. In the meantime, this part of the play area will remain off-limits to children.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Tashima Daniel

LICENSING EVALUATOR NAME:

Nancy Diaz

LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

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: NHA - WALKER HEAD START	FACILITY NUMBER: 376600839
	VISIT DATE: 10/12/2022

NARRATIVE

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Children were observed to be under the supervision of qualified staff. Facility was observed to be within ratio. An isolation area has been designated for children who becomes ill during the day.

Children’s records were reviewed today. All required forms were on file. Menus are posted in a place visible by the child’s authorized representative. All children are signed in/out by a representative who uses a full legal signature and has recorded the time of day. Child’s record also contain a medical assessment.

Staff records reviewed today contain a health screening as required by the regulation.
Staff have completed the mandated reporter training (effective 3/2018). This training shall be renewed every two years. All staff have immunization record indicating that they have been immunized against influenza, pertussis and measles.

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

Ms. Holland 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.

LPA discussed the safe sleep regulations with Ms. Holland and discussed 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 Ms. Holland 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.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

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: NHA - WALKER HEAD START	FACILITY NUMBER: 376600839
	VISIT DATE: 10/12/2022

NARRATIVE

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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.

TYPE B DEFICIENCY WAS CITED TODAY.

Exit interview was conducted with Ms. Holland. A copy of the licensing report and appeal rights were provided today. Notice of site visit was also provided and observed posted today.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

LIC809 (FAS) - (06/04)

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