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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700359
Report Date: 01/06/2023
Date Signed: 01/06/2023 03:46:24 PM


Document Has Been Signed on 01/06/2023 03:46 PM - 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:CHABAD HEBREW ACADEMY - INFANTFACILITY NUMBER:
376700359
ADMINISTRATOR:DEVORAH FRADKINFACILITY TYPE:
830
ADDRESS:10785 POMERADO ROADTELEPHONE:
(858) 566-1996
CITY:SAN DIEGOSTATE: CAZIP CODE:
92131
CAPACITY:12CENSUS: 8DATE:
01/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:38 AM
MET WITH:Assistant Director, Mairav Boudjnah TIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Jennifer Lott conducted an annual licensing inspection. LPA was greeted by Assistant Director, Mairav Boudjnah and granted entry after identifying herself and disclosing the purpose of her visit. During today's inspection, there were 8 infants with 5 staff present. Appropriate ratios and capacity were observed.

Furniture and age appropriate equipment is in good condition and there is adequate heating, lighting, ventilation. Floors appear to be clean and safe. Filtered drinking water is readily accessible.

Facility does not provide food service in the infant room as all parents provide food /snacks. However if additional meals are needed the school will provide premade meals. Cleaning supplies are kept separate from food and are inaccessible to children. Storage containers for solid waste have tight-fitting covers and are kept in good repair. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 F or less. The facility appears to be free of insects and rodents. There is an operational carbon monoxide detector at the facility. Assistant Director, Boudjnah states there are no weapons or ammunition stored at the facility.

Outdoor play area is fenced and playground has sufficient material for cushioning. There also is a waiver on file for shared outdoor space. There are no bodies of water at this facility. Area has awning attached to building for shade. Equipment is age appropriate. Drinking water readily accessible and grounds are free of debris or potential hazards.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:
DATE: 01/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/06/2023
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: CHABAD HEBREW ACADEMY - INFANT
FACILITY NUMBER: 376700359
VISIT DATE: 01/06/2023
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Personnel records contain health screening documentation, immunizations and at least one staff member has current CPR and First Aid certifications. Infant care teachers meet educational requirements. All staff have completed Mandated Reporter training and obtained criminal record clearances or exemptions. Assistant Director, Boudjnah, was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Sign in sheets were reviewed. Children’s records contain admission agreements and medical assessments. There are no walkers, bouncy seats, exersaucers or jumpers in the room. Feeding tables have broad-based legs, plastic seats in good repair. Hazardous materials are inaccessible to children. Bottles, dishes and containers of food brought by infant’s authorized representative are labeled with the infant’s name and current date. The changing table was within arm's reach of sink. There are no potty chairs at this time as no children are being potty-trained currently.

Caregivers wash hands before and after each feeding and each diaper change and wear gloves. Toys are safe, with no sharp edges, splinters or protruding points, nor small parts that can be pulled off and swallowed. Floor mats and cots are available for infants able to climb out of cribs. Cribs or napping equipment are available. Bedding is identified and stored separately for each infant. Napping infants are under visual observation by staff. Indoor activity space is physically separate from other components. Facility maintains individual feeding plans for each infant and has up to date Infant Needs and Services Plans for each infant on file.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023
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: CHABAD HEBREW ACADEMY - INFANT
FACILITY NUMBER: 376700359
VISIT DATE: 01/06/2023
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LPA discussed the safe sleep regulations with Assistant Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Assistant Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed medication storage, however the facility does not provide medication assistance at this time. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

Based on today’s visit, no deficiencies were observed at this time. An exit interview was conducted with Assistant Director, Mairav Boudjnah. A copy of this report, Appeal and Licensee Rights (LIC 9058) as well as Notice of Site Visit Form (LIC 9213) will be emailed to the Assistant Director. Signature below confirms receipt of these documents. Licensee acknowledges that the LIC 9213 is required to be posted for 30 days.

Due to computer printer issues, this report will be emailed to the Assistant Director. An email read receipt will confirm the documents have been received.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023
LIC809 (FAS) - (06/04)
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