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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600966
Report Date: 08/31/2022
Date Signed: 09/01/2022 11:42:05 AM


Document Has Been Signed on 09/01/2022 11:42 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:CHILDREN'S CHOICE - SCHOOL-AGEFACILITY NUMBER:
376600966
ADMINISTRATOR:FREDA SIMMONSFACILITY TYPE:
840
ADDRESS:1465 EAST MADISON AVENUETELEPHONE:
(619) 442-4014
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:28CENSUS: 0DATE:
08/31/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Director Freda SimmonsTIME COMPLETED:
11:45 PM
NARRATIVE
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On 9/1/2022 @ 11:00 a.m., Licensing Program Analyst, Joelle Redding, made an unannounced visit to follow up on a self-reported incident.

On 8/26/22, Child #1 was injured when Staff #1 tapped the breaks on the school van to demonstrate what could happen if a child was not seated properly. Staff #1 has since been let go.

LPA informed Director Freda Simmons, that this report, dated 9/1/2022, which documents a Type A citation shall be posted for 30 consecutive days as there was an immediate risk to the health, safety, or personal rights of children in care.

LPA also informed the Director to provide a copy of this licensing report, dated 9/1/2022, that documents the Type A citation, to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview was conducted, appeal rights were provided and reviewed. LIC 9224 was provided.

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.

SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2022
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 09/01/2022 11:42 AM - It Cannot Be Edited

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: CHILDREN'S CHOICE - SCHOOL-AGE
FACILITY NUMBER: 376600966

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/31/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/02/2022
Section Cited

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Personal Rights. The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from... intimidation...threat... or other actions of a punitive nature...

This requirement was not met as evidenced by
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Based on review of documentation and interviews, Staff #1 tapped on the breaks while children were in the school van, to show what can happen if they were not seated properly resulting in an injury to Child #1. This is a form of intimidation/threat and is a immediate risk to the heath and safety of children in care.
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been reminded of proper procedures to take to protect the health and safety of children during transport.

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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: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 09/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/01/2022
LIC809 (FAS) - (06/04)
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