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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600992
Report Date: 03/10/2020
Date Signed: 03/10/2020 11:38:32 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:NHA URBAN VILLAGE II HEAD STARTFACILITY NUMBER:
376600992
ADMINISTRATOR:WEBB, BRENDAFACILITY TYPE:
850
ADDRESS:4305 UNIVERSITY AVENUE STE 107TELEPHONE:
(619) 284-5644
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY:88CENSUS: 74DATE:
03/10/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Site Supervisor Brenda WebbTIME COMPLETED:
11:45 AM
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LPA, Luigi Gargaro, conducted an unannounced visit to the facility today to follow up on a 10/11/19 incident that was self reported by the facility in which child #1 stated that she was pinched by an unidentified staff member.

During today's visit, analyst conducted interviews with the director and staff members who teach in the classroom and were present at the time of the reported incident. The child involved in the incident is no longer attending the preschool classroom program at NHA. Analyst did, however, review staff video recordings of the child to confirm her language and social development skills.

Based on the testimony obtained and reviewed documentation, analyst found that there was insufficient evidence to confirm whether child in care was inappropriately contacted and by whom and whether it may or may have not occurred at the facility. No further action is required. Analyst reviewed report with site supervisor, had her sign it and provided copy for her records.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi GargaroTELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2020
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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