376700631-3-14-2023-51-CC-SSIO-CPWQKH-20230314121421

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700631
Report Date: 03/14/2023
Date Signed: 03/14/2023 12:14:33 PM

Document Has Been Signed on 03/14/2023 12:14 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:	DEL NORTE HIGH PRESCHOOL		FACILITY NUMBER:	376700631
ADMINISTRATOR:	MARA NACU		FACILITY TYPE:	850
ADDRESS:	16601 NIGHT HAWK LANE		TELEPHONE:	(858) 487-0877
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92127
CAPACITY:	42	CENSUS: 30	DATE:	03/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Kristie Spillane/Preschool Operation Supervisor		TIME COMPLETED:	12:20 PM

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	On 03/14/2023 at 9:25 AM, Licensing Program Analyst (LPA) Selina Siao conduct an annual inspection. Facility operates from 8:45am-11;45am. Upon arrival, the following ratios were observed: Room A125 had 15 children supervised by teachers Tess Akrawi, Karolina Danylenko and Shantha Shankaramurthy. Room A124 had 15 children supervised by substitute teachers Sangita Shah, Manisha Maiti and Zahra Gholami. Facility is within title 5 staffing ratio. Preschool Operation Supervisor Kristie Spillane arrived to the facility during the inspection. All required notices, forms and license were posted. Furniture and age appropriate equipment is in good condition. Rooms have adequate heating, lighting, ventilation and drinking water. Storage cubbies are readily available, and room accommodates class size. The bathrooms are located inside room A124 and they are maintained with operational toilets and faucets with appropriate temperature. Paper towels and toilet paper are available. Bathrooms are lighted and has ventilation. Food service area consists of a kitchen located on the Del Norte High campus. Menu is posted in the classroom. Adequate food is available for meals and snacks. Cleaning supplies are kept out of reach of children. Outdoor play area is a fenced playground with sufficient turf for cushioning. Climbing structures and slides are securely fixed to the ground. Area has three umbrellas used for shade. Equipment is age appropriate and separated by age groups preschool. Children bring there own water bottle to drink for indoor and outdoor activity. Outdoor area has an operational drinking fountain and grounds are free of debris or potential hazards. LPA reviewed sign in sheets, first aid supplies and reviewed medication policy and storage, all areas are within compliance. Isolation area is the outside playground located next to room A124 or the office located in the front room. Personnel and client records were reviewed, and staff members have completed the online mandated reporter training. All personnel have required criminal record and child abuse index clearances or exemptions. LPA reviewed Emergency Disaster Plan and last fire drill was conducted on 02/07/2023. Facility has an operating carbon monoxide detector located in room A124. Facility has at least one staff member that has a valid EMSA approved CPR/FA when children are in care.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina Siao	TELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

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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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: DEL NORTE HIGH PRESCHOOL	FACILITY NUMBER: 376700631
	VISIT DATE: 03/14/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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 link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website at https://cdss.ca.gov/inforesources/community-care-licensing/subscribe. LPA discussed California Megan's Law with provider and advised her to go on the website at www.meganslaw.ca.gov.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Facility representative Kristie Spillane was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

All unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619)767-2203.

Refer to the next page LIC 809D for deficiency citation. An exit interview was conducted, and appeal rights were provided.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina Siao	TELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/14/2023 12:14 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: DEL NORTE HIGH PRESCHOOL	FACILITY NUMBER: 376700631
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as two out of six employee's immunization records are not available for review. Missing MMR for for staff S.S and MMR and TDAP for staff T.A. Which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/10/2023
	Plan of Correction
1 2 3 4	Facility rapresentative stated that she will obtain the above staff members required immunization records and she will submit the documents to Licensing no later than 04/10/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina Siao	TELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

LIC809 (FAS) - (06/04)

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