376700611-11-15-2019-20-CC-ACAN-BHXQMC-20191115111720

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700611
Report Date: 11/15/2019
Date Signed: 11/15/2019 11:17:34 AM

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:	JUAREZ-LINCOLN STATE PRESCHOOL		FACILITY NUMBER:	376700611
ADMINISTRATOR:	TONI FADDIS		FACILITY TYPE:	850
ADDRESS:	849 TWINING AVENUE		TELEPHONE:	(619) 690-9222
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92154
CAPACITY:	27	CENSUS: 21	DATE:	11/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Diana Castaneda		TIME COMPLETED:	11:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA), Adrian Castellon conducted the visit. LPA met with PM lead teacher and discussed the purpose of the visit. LPA was given access to inspect the facility. The facility provides AM and PM sessions in room 806. The appropriate ratios and capacity were observed. Appropriate care & visual supervision were also observed during the visit. There are no bodies of water present. All children are being supervised, including visual observation, of a teacher or assistant during the visit. The facility is operating within the conditions, limitations and capacity specified on the license. The disinfectants, cleaning solutions, poisons and other dangerous items are inaccessible to children. The furniture, equipment and supplies are age appropriate and are in good condition. The room has adequate lighting, and ventilation. The floors are found to be clean and safe. The drinking water is uncontaminated and is readily accessible, inside and outside. The restrooms are maintained with operational toilets and faucets with appropriate temperature. Soap , paper towels, and toilet paper are available. The restroom is lighted and ventilated. Outdoor play area is a fenced playground with sufficient cushioning. Climbing structures and slides are securely fixed to the ground. Area provides shade structures. Equipment is age appropriate. Area and grounds are free of debris or potential hazards . Menu is posted. LPA reviewed sign in sheets, first aid supplies and reviewed medication policy and storage, all areas are in compliance. Isolation area is the office. Personnel and client records were reviewed. All personnel have required criminal record and child abuse index clearances or exemptions. LPA reviewed Emergency Disaster Plan requirement. Reporting requirements and AB633 was also reviewed. The following items were requested to be updated at all times: Personnel Report, Emergency Disaster Plan and Designation of Responsibility. A copy of this report must be maintained at the facility for public review.

SUPERVISOR'S NAME: Joe Carrasco	TELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019

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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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: JUAREZ-LINCOLN STATE PRESCHOOL	FACILITY NUMBER: 376700611
	VISIT DATE: 11/15/2019

NARRATIVE

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This facility does provide Incidental Medical Services- IMS. A written plan of operation has already been submitted to CCL effective today, LPA will review as soon as possible. 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 http://www.ada.gov/childqanda.htm

Immunization law (SB792) was discussed with and she understands that anyone who provides care and supervision to the children must have immunization records maintained at the facility for: pertussis, measles, and influenza. Facility is compliant with SB792.

LPA Castellon discussed the new Mandated Reporter training, AB1207. Facility is compliant with AB1207.

There were not any deficiencies issued throughout today's annual inspection. NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS. LPA observed the posting the Notice of Site Visit.

Duty Line: (619) 767-2248, Monday through Friday from 8am to 5pm. To access our Regulation and Forms please use our WEBSITE: http://ccld.ca.gov

SUPERVISOR'S NAME: Joe Carrasco	TELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019

LIC809 (FAS) - (06/04)

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