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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700417
Report Date: 07/20/2023
Date Signed: 07/20/2023 04:49:42 PM


Document Has Been Signed on 07/20/2023 04:49 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:SKYLINE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
376700417
ADMINISTRATOR:JACQUELINE SERRANOFACILITY TYPE:
830
ADDRESS:11330 CAMPO ROADTELEPHONE:
(619) 415-5485
CITY:LA MESASTATE: CAZIP CODE:
91941
CAPACITY:45CENSUS: 0DATE:
07/20/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Jacqui Serrano and Chad BickleyTIME COMPLETED:
05:00 PM
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On 07/20/2023 at 04:00pm an office meeting was conducted with Licensee Representative, Chad Bickley (present via speakerphone) to discuss deficiencies cited on 05/22/2023 and 01/06/2023. Present at the meeting was Center Director, Jacqueline Serrano, Licensing Program Manager (LPM), Tulam Vu and Licensing Program Analyst (LPA), Vicky Williamson.

On 05/22/2023 during a case management inspection, the facility was cited Type A, Section 101229(a)(1) Responsibility for Providing Care and Supervision: A two year old daycare child was left on the playground without supervision for approximately 6 minutes. On 01/06/2023, the facility was cited Type B, Section 101223(a)(2) Personal Rights: The facility staff gave a breast milk bottle to the wrong child. It is noted that the director corrected all deficiencies in a timely manner. Director stated that all staff members have received training and reviewed video on CCL website for Supervision.

LPM discussed with Licensee Representative, Chad Bickley and Director, Jacqueline Serrano the above deficiencies. The Director was provided with the following resources: A Technical Support Program (TSP) brochure, for questions related to the TSP, email: childcaretechnicalsupport@dss.ca.gov. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov., sdincidentreports@dss.ca.gov and the Duty Line 619-767-2248. Please submit your Unusual Incident Report by email to: SDIncidentReports@dss.ca.gov or by Fax at (619) 767-2203.

The Director was provided regulation Section 101229(a)(1); Responsibility for Providing Care and Supervision and the Best Practices Lack of Supervision handout. Licensee Representative and Director were informed that repeated violations or failure to comply with licensing laws and regulations may result in administrative action taken by the Department. Licensee Representative and Director stated they understand and will ensure the facility complies with all regulations and laws governing Child Care Centers. Licensee Representative authorized Director, Jacqueline Serrano, to sign the report.

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/20/2023
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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