<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600887
Report Date: 10/27/2022
Date Signed: 10/27/2022 12:05:34 PM


Document Has Been Signed on 10/27/2022 12:05 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:ECS MONTGOMERY HEAD STARTFACILITY NUMBER:
376600887
ADMINISTRATOR:JAQUELINE ANDRADEFACILITY TYPE:
850
ADDRESS:3240 PALM AVENUETELEPHONE:
(619) 424-4027
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY:120CENSUS: 68DATE:
10/27/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Jacqueline Andrade, DirectorTIME COMPLETED:
12:20 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
On 10/27/2022, at 9:25 am., Licensing Program Analysts (LPAs) Michelle Hood and Julissa Valle, made an unannounced inspection to follow up on a self-reported incident that occurred on 10/14/2022 wherein Child #1 (C1) and Child #2 (C2) both four years old were discovered by Staff #1 (S1), in the playground caterpillar tunnel. S1 stated that C1 was observed attempting to inappropriately touch C2. .

During the tour of the facility with the director, LPAs observed the following:
Classroom 1A: five children and two staff
Classroom 1B: seven children and three staff
Classroom 2: fifteen children and three staff
Classroom 3: fourteen children and three staff
Classroom 4: sixteen children and three staff
Classroom 6: six children and two staff
Classroom 9: five children and three staff

LPAs inspected the play area for classroom #4 and the areas where S1 and other staff was positioned. The LPAs inspected the caterpillar tunnel and where the two children were observed at the time of the incident. LPAs interviewed Director, three staff, and two children. On the day of the incident, there was three staff with sixteen children from classroom #4 on the playground.

Ratios were met, supervision was in place, the staff responded appropriately and the facility reported timely.

An exit interview was conducted and the report was reviewed with the licensee (include name). The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiencies were cited.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:
DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/27/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1