376600883-10-29-2019-20-CC-SSAA-BHEN6N-20191029101126

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600883
Report Date: 10/29/2019
Date Signed: 10/29/2019 10:11:32 AM

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:	LA MESA DALE PRESCHOOL		FACILITY NUMBER:	376600883
ADMINISTRATOR:	RABASCO, KELLEY		FACILITY TYPE:	850
ADDRESS:	4370 PARKS AVENUE		TELEPHONE:	(619) 668-5740
CITY:	LA MESA	STATE: CA	ZIP CODE:	91941
CAPACITY:	24	CENSUS: 23	DATE:	10/29/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Cynthia Woods		TIME COMPLETED:	10:30 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	Licensing Program Analyst (LPA) Samantha Salunga visited the facility for the purpose to conduct an annual random inspection. Upon arrival LPA met with Lead Teacher, Cynthia Woods and proceeded to tour the facility. Also present were a total of 23 children in Room 19 with Karen Welsch (Paraprofessional) and Yvette Porter-More (Substitute). Appropriate ratios and capacity were observed. Furniture and age appropriate equipment is in good condition indoors and outdoors. Children's toilets and hand washing facilities are sanitary. Rooms are safe and clean. Facility is a half day program. Children do not nap on site. Bathrooms are safe and sanitary, maintained with operational toilets and faucets with appropriate temperature. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. Lunch is prepared by the school's central cafeteria. Children are provided drinking water from an operation water fountain inside and outside the classroom. All disinfectants, cleaning solutions, and other hazardous items are inaccessible to children through latches and locks. Outdoor play area is fenced with adequate material for cushioning. Area has canopies/trees used for shade. There are no bodies of water or weapons at this facility. No excluded individuals are present. Last fire drill was conducted and documented on 09/04/2019. There is an operational carbon monoxide detector at the facility. First Aid/CPR reviewed and in compliance. Sign in/sign out sheets are well maintained. Admission Agreement forms reviewed for some children. Staff records contain documentation of education, training, and/or experience. Menus are posted. Immunization records per SB792 and Mandated Reporter Training Certificate per AB1207 was reviewed and in compliance. LPA obtained updated children's roster, LIC610, and LIC500. LPA also conducted a follow-up regarding an incident that occurred on 09/19/2019 where Child #1 sustained a concussion by walking into a pole. LPA conducted an interview with Ms. Woods regarding incident. Incident was observed by staff and was known to be an accident. Related documentation was obtained via email (medical report). No further follow-up needed. Ms. Woods was provided LIC9102TA at conclusion of visit. See 809-C for continuation...

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha Salunga	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019

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: LA MESA DALE PRESCHOOL	FACILITY NUMBER: 376600883
	VISIT DATE: 10/29/2019

NARRATIVE

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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

Ms. Woods was advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information.
Duty Line was provided: (619) 767-2248. LPA also discussed California Megan's Law and LPA provided Ms. Woods with the following website: www.meganslaw.ca.gov

No deficiencies observed in the areas inspected during today's visit. NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS. LPA observed Ms. Woods post notice of site visit.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha Salunga	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019

LIC809 (FAS) - (06/04)

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