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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700462
Report Date: 06/19/2019
Date Signed: 06/19/2019 12:32:09 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:ECS ZAMORANO HEAD STARTFACILITY NUMBER:
376700462
ADMINISTRATOR:MARIE ALZINAFACILITY TYPE:
850
ADDRESS:7375 TOOMA STREETTELEPHONE:
(619) 434-5780
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY:80CENSUS: 0DATE:
06/19/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Marina Lopez, Family Support Tech.TIME COMPLETED:
12:35 PM
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Licensing Program Analyst (LPA) D. Sanchez, made an unannounced follow up Case Management inspection to the facility today in response to an Unusual Incident/Injury Report received in the San Diego Child Care Regional Office (SDCCRO) on 4/26/2019. Incident report states that on 4/25/2019, during the activity of music movement, child #1 accidentally fell on the floor and hurt forehead on the carpet area.

LPA inspected classroom area where incident took place. Area is clear and there are no tripping hazards. LPA also interviewed facility staff and reviewed child's record during today's inspection.

LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

There are no deficiencies cited on this incident, all paperwork is in order and required documents were properly posted.

Community Care Licensing WEB SITE: http://www.ccld.ca.gov

An exit interview was conducted with Marina Lopez and a copy of this report left at the facility.

LPA observed provider placing the Notice of Cite Visit on the wall visible to parents during today’s inspection.

NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana SanchezTELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
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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