376700255-6-17-2019-51-CC-VWIN-BD8SZH-20190617141910

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700255
Report Date: 06/17/2019
Date Signed: 06/17/2019 02:19:19 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:	RANCHO SAN DIEGO ELEMENTARY PRESCHOOL		FACILITY NUMBER:	376700255
ADMINISTRATOR:	CHERIE WALL		FACILITY TYPE:	850
ADDRESS:	12151 CALLE ALBARA		TELEPHONE:	(619) 588-3211
CITY:	EL CAJON	STATE: CA	ZIP CODE:	92019
CAPACITY:	49	CENSUS: 16	DATE:	06/17/2019
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Virginia Fessler		TIME COMPLETED:	02:30 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	Licensing Program Analyst Vicky Williamson conducted an annual required inspection. LPA met with Virginia Fessler, Lead II Teacher. The facility operates Monday - Friday from 8:00 am to 1:45 pm. The indoor and outdoor of the facility was inspected. Classroom K- 2 had 16 children with 3 teachers. Children were observed to be under visual supervision. The classrooms and restrooms have adequate lighting, heating, and ventilation. Facility has a shared bathroom waiver on file. All floors appeared to be safe and clean. Furniture, children's cubbies and toys appeared to be in good condition. Trash cans have a tight-fitting covers and are in good repair. Disinfectants, cleaning solutions and other hazardous items are stored behind latched cabinets. Children bring their own lunch. Snack menu is posted monthly. The Nutrition Program located at the Cajon Valley School District office provides snack to the facility. Sign in/out sheets were reviewed and did not show parent/guardian’s signature and time of day recorded for 3 children present. The storage areas appeared to be clean. Facility appeared to be free of flies, other insects and rodents. The surface of the outdoor activity space is maintained in a safe condition with sufficient shade. Drinking water is available inside the classrooms and outdoor play area. There are no bodies of water and weapons present on the premises. The last fire drill was documented on 6/4/19. The school campus nurse's office is designated for use by children who are ill. A sample of children records, including medical assessment and emergency information were reviewed. Staff's records, including transcripts, teacher qualifications and experiences were reviewed. Opening and closing staff members have current CPR and First Aid certifications. Staff caregiver background checks, criminal record and child abuse index clearances or exemptions are verified through the Cajon Valley School District.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

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: RANCHO SAN DIEGO ELEMENTARY PRESCHOOL	FACILITY NUMBER: 376700255
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/17/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/17/2019 Section Cited	1 2 3 4 5 6 7	Sign In and Sign Out -The person who brings the child to, and removes the child from, the center shall sign the child in/out. The requirement was not met as evidence by: Review of sign in/sign out sheets, it was
	8 9 10 11 12 13 14	determined that 3 children present during the time inspection were not signed in or out. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

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: RANCHO SAN DIEGO ELEMENTARY PRESCHOOL	FACILITY NUMBER: 376700255
	VISIT DATE: 06/17/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA and Lead Teacher Virginia Fessler discussed reporting requirements and sign in / sign out requirements. Director was provided information on the Effects of Lead Exposure.

To access our Regulation and Forms please use our WEBSITE: http://ccld.ca.gov

Please update and submit forms LIC 308, LIC 309, LIC 500, and Parent Handbook to the Licensing Agency by June 28, 2019.

See LIC 809D for deficiencies cited. Facility was provided a copy of the appeal rights form LIC 9058 and the signature on this form acknowledges receipt of these rights.
The Notice of Site Visit (LIC 9213) was provided to be posted at the facility for 30 days. LPA observed form LIC 9213 posted.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

LIC809 (FAS) - (06/04)

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