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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700376
Report Date: 04/07/2022
Date Signed: 04/07/2022 12:03:39 PM


Document Has Been Signed on 04/07/2022 12:03 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:CENTER FOR CHILDREN & FAMILIES AT CAL STATE SMSFACILITY NUMBER:
376700376
ADMINISTRATOR:LETISIA FORDFACILITY TYPE:
850
ADDRESS:453 LA MOREE ROADTELEPHONE:
(760) 750-8750
CITY:SAN MARCOSSTATE: CAZIP CODE:
92078
CAPACITY:176CENSUS: 99DATE:
04/07/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Hannah Stehling, Assistant DirectorTIME COMPLETED:
12:10 PM
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On April 7, 2022 at 8:40 a.m. Licensing Program Analyst, Leilani Curtis, conducted an unannounced inspection to follow up on a self-reported incident that occurred on 3/29/22, wherein a 3-year-old child (C1) was left unattended in a classroom. LPA met with Assistant Director Hannah Stehling and proceeded to tour the facility. There were 99 children with 15 staff members present. Appropriate ratio/capacity were observed. Staff members have the required background clearances and are associated to the facility.

LPA interviewed child #1 (C1), staff #1 (S1), staff #2 (S2) and staff #3 (S3). S2 was interviewed via telephone while at the facility. On 3/29/22, the date of the incident, there were 23 children with 4 staff members outside on the playground. Proper ratios were in place. At approximately 3:46 p.m. S1 was on the playground when she noticed C1 unattended inside of the preschool #1 classroom. The child was looking out of the classroom door window. S1 opened the classroom door and retrieved the child. C1 was not injured or harmed. None of the staff members saw the child go inside of the classroom. S2 states that she went on break at 3:39 p.m., walked through the classroom but did not see C1. C1 was left unattended in the classroom for approximately 7 minutes. The parent of C1 was notified of the incident the same day. Assistant Director Stehling states that the incident was discussed with staff members. On 3/14/22 the facility director conducted a staff meeting/training on the responsibility for providing care and supervision to children and proper Child Supervision Record keeping due to a prior incident regarding lack of supervision which occurred on 3/2/22. LPA obtained written statements obtained by the director from S1, S2 and S3.

See LIC809D for cited deficiency. A civil penalty has been assessed.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of the Fact Sheet - AB 633 Child Care Parent Notification Requirements and a copy of LIC 9224 was given to Assistant Director Stehling
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 04/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2022
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: CENTER FOR CHILDREN & FAMILIES AT CAL STATE SMS
FACILITY NUMBER: 376700376
VISIT DATE: 04/07/2022
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An exit interview was conducted with Miss. Stehling and Appeal Rights (LIC 9058 1/16) were discussed. Director Letisia Ford arrived at the facility at 12:00 p.m. LPA reviewed report with the director. Miss Stehling's signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed the assistant director post notice of site visit.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/07/2022 12:03 PM - It Cannot Be Edited

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: CENTER FOR CHILDREN & FAMILIES AT CAL STATE SMS
FACILITY NUMBER: 376700376

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/20/2022
Section Cited

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101229(a)(1) Responsibility for Providing Care and Supervision: (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by:
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Based on interviews with staff #1, staff #2 and staff #3, child #1 (C1) was left unattended in a classroom for approximately 7 minutes on 3/29/22. This poses a immediate health and safety risk to children in care.
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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 DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 04/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2022
LIC809 (FAS) - (06/04)
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