376700139-1-13-2020-51-CC-NDIZ-BKSNZE-20200113095412

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700139
Report Date: 01/13/2020
Date Signed: 01/13/2020 09:54:23 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:	ST. MARK LUTHERAN CHURCH AND PRESCHOOL		FACILITY NUMBER:	376700139
ADMINISTRATOR:	LEWIS, ANNE K.		FACILITY TYPE:	850
ADDRESS:	552 S. EL CAMINO REAL		TELEPHONE:	(760) 231-1917
CITY:	ENCINITAS	STATE: CA	ZIP CODE:	92024
CAPACITY:	47	CENSUS: 20	DATE:	01/13/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:16 AM
MET WITH:	Annette Conrad		TIME COMPLETED:	10:10 AM

NARRATIVE

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LPA Nancy Diaz conducted an unannounced annual site inspection today. LPA met and toured the facility with Annette Conrad, Site Director. All required notices, forms and license were posted in an area visible to the parents or authorized person. There were 20 children in the play yard engaged in various outdoor activities with staff Cassie Conrad, Linda Pullara & Dorothy Lesch. Children-staff ratio maintained in all the play yard.

There were no bodies of water observed within the premises. Mrs. Conrad stated that they don't maintain weapons in the facility. Disinfectants, cleaning solutions, poisons, medications and other similar items are inaccessible to children. Furniture and playground equipment are kept in good condition, free of sharp, loose or pointed parts. All toilets and handwashing facilities are safe and working in sanitary condition. All floors are kept clean and safe. Kitchen, food preparation and storage areas are kept clean, free of litter, rubbish or rodents and other vermin.

The surface of the outdoor activity space are maintained in a safe condition and free of hazards. All storage containers for solid waste have a tight-fitting covers that are kept on and in good repair. Uncontaminated drinking water are readily available both indoors and outdoor. The areas under high climbing equipment, slide are cushioned with materials that absorbs a fall.

All staff records were reviewed today. A random sampling of children's files were also conducted.

At least one person trained in CPR and Pediatric First Aid is present. Facility maintains current children’s record including emergency phone numbers of authorized representatives and medical assessment. Personnel record maintained on all staff included health screening. A handout was provided to the director today on “Effects of Lead Exposure”. Director shall provide a copy of this handout to all the daycare parents.

CONTINUED

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2020

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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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: ST. MARK LUTHERAN CHURCH AND PRESCHOOL	FACILITY NUMBER: 376700139
	VISIT DATE: 01/13/2020

NARRATIVE

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The licensee has not exceeded the conditions, limitations and capacity specified on the license.

A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances.

The following handouts were provided to the Site Director today:

- PIN 19-10-CCP – U.S. Consumer Product Safety Commission recall

- PIN 19-09-CCP – Head Lice Information for Child Care Providers
- Health & Human Services Agency Guidance on Head Lice Prevention and Control
- PIN 19-08-CCP – CA Department of Public Health New Pre-Kindergarten Immunization requirements
- PIN 19-06-CCP – U.S. Consumer Product Safety Commission recall
- PIN 19-02-CCP – Safe Sleep Awareness Campaign

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website. Please go to www.ccld.ca.gov and click on Child Care, go under Quick Links and Quarterly updates, click on “Receive Important Updates” then enter your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

LPA observed the Representative post the Notice of Site Visit in a prominent place. The Representative states it is understood that this notice must be posted for 30 days.

TYPE B DEFICIENCIES WERE CITED TODAY. TYPE B IF NOT CORRECTED POSES A POTENTIAL RISK TO THE HEALTH, SAFETY OR PERSONAL RIGHTS OF CHILDREN IN CARE.

CONTINUED

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2020

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: ST. MARK LUTHERAN CHURCH AND PRESCHOOL	FACILITY NUMBER: 376700139
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/13/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/23/2020 Section Cited	1 2 3 4 5 6 7	H & S Section 1596.8662 create requirements for mandated child abuse reporter training. Applicants, licensees, and facility employee may meet this requirement free of cost by accessing the online training module provided on the Department of Social Services, Mandated Reporter Training Website: www.mandatedreporterca.com (effective 1/1/2018)
	8 9 10 11 12 13 14	This regulation was not met as evidenced by LPA's review of staff files. The following staff were missing the required Mandated reporter as required by AB1207:Cassie Conrad; Jill Cook and Linda Pullara	8 9 10 11 12 13 14
Type B 01/23/2020 Section Cited	1 2 3 4 5 6 7	CCC - H & S Section 1596.7995. Effective September 1, 2016, a person may not be employed or volunteer at a child care center unless he or she has been immunized against influenza, pertussis, and measles. This requirement was not met as evidenced by LPA's review of staff record. Staff Jill Cook is missing the required Pertussis, Measles and Influenza immunization. Staff Dorothy Lesch is missing the required Pertussis immunization.
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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: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy Diaz	TELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2020

LIC809 (FAS) - (06/04)

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