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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700045
Report Date: 04/21/2021
Date Signed: 04/21/2021 01:21:35 PM

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:CARLSBAD EDUCATIONAL FOUNDATION-BUENA VISTA ELEM.FACILITY NUMBER:
376700045
ADMINISTRATOR:AIMEE SCHMIDTFACILITY TYPE:
840
ADDRESS:1330 BUENA VISTA WAYTELEPHONE:
(760) 929-1555
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY:140CENSUS: 5DATE:
04/21/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:38 AM
MET WITH:Aimee SchmidtTIME COMPLETED:
12:15 PM
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On 04/15/2021 at 11:38am, Licensing Program Analyst (LPA) Samantha Salunga conducted an unannounced virtual inspection to follow-up on a possible lack of care and supervision incident that occurred on 02/11/2021. Due to COVID-19, an unannounced tele-inspection was conducted using Face Time to tour the facility with Aimee Schmidt, Site Coordinator. LPA observed Ms. Schmidt supervising a total of 5 children in Room 26. Appropriate ratios and supervision were observed today.

The incident was self-reported by the facility regarding a day care child who sustained three broken bones in his foot. Interviews were conducted with several staff members and children and confidential information was obtained throughout the investigation. Based on information obtained during the investigation, the agency could not substantiate lack of care and supervision during the incident. No violations were noted from the incident per CCR, Title 22 regulations governing child care centers.

An exit interview was conducted, and appeal rights were provided to facility representative. A notice of site visit was provided and to be posted at the facility for 30 days and failure to keep it posted will result in a $100 civil penalty. A copy of this report and appeal rights (LIC 9058 01/16) were reviewed during inspection and will be e-mailed to Ms. Schmidt.
Ms. Schmidt was advised that acknowledgement of the receipt of the report is to be received within twenty-four hours.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2021
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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