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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700510
Report Date: 06/03/2019
Date Signed: 06/03/2019 03:43:22 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:CHILDREN'S CHOICE LEARNING CONNECTIONFACILITY NUMBER:
376700510
ADMINISTRATOR:TARYN HILLFACILITY TYPE:
850
ADDRESS:1268 & 1276 N. SECOND STREETTELEPHONE:
(619) 442-1685
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:55CENSUS: 35DATE:
06/03/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Jenni Grawvunder, Area Director TIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Michelle Hood made an unannounced visit to follow up on a self-reported incident that occurred on 05/10/2019, wherein a 4 year old was playing soccer with another child in care. While playing soccer child was flipping, sliding and doing cart wheels on turf. At time of incident, child kicked ball then laid down on turf when another child landed on top of child. Child sustained a broke bone between thumb and pointing finger.

LPA examined area where incident occurred. On day of incident there were 12 children and 2 staff members on playground. No prior incidents have occurred in this area.

It appears this is an isolated incident. Supervision was in place, ratios were met and staff responded appropriately. The facility reported timely.

No deficiencies are cited. Provided Notice of Site Visit (LIC 9213). Exit interview conducted. LPA observed staff post LIC9213.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019
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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