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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700733
Report Date: 03/02/2023
Date Signed: 03/02/2023 11:39:16 AM


Document Has Been Signed on 03/02/2023 11:39 AM - 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:ST. ROSE OF LIMA PRE-SCHOOLFACILITY NUMBER:
376700733
ADMINISTRATOR:MARTINEZ, GLENDAFACILITY TYPE:
850
ADDRESS:278 ALVARADO STREET, UNIT 2TELEPHONE:
(619) 422-1121
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:44CENSUS: 30DATE:
03/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Ilse BernalTIME COMPLETED:
11:45 PM
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On March 3, 2023, at 9:30 a.m.,  Licensing Program Analyst (LPA) Adrian Castellon conducted an unannounced Required/Annual Inspection and met with lead teacher Ilse Bernal.  LPA disclosed the purpose of the inspection and toured the facility indoors and outdoors.  This is a full day program which operates on a traditional school year schedule.  Days and hours of operation are Monday- Friday. The program operates from 6:30am to 5:00pm Appropriate ratios were observed on this date. Classrooms #3 and #4 are used for daycare purposes.


There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises.  Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts.  Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards.  All toilets and hand washing facilities are in safe and sanitary operating condition.  Floors in the facility are clean and safe. All food is protected against contamination and any contaminated food is discarded immediately.  Solid waste storage containers have tight-fitting covers and are in good repair.  Drinking water is available both indoors and outdoors.  Water jugs and foam cups are used for water purposes. Areas around high climbing equipment, swings and slides have cushioning material to absorb falls.  The facility is free of flies, insects and rodents.  Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.  
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2023
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: ST. ROSE OF LIMA PRE-SCHOOL
FACILITY NUMBER: 376700733
VISIT DATE: 03/02/2023
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A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained.  At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities.  The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department.  The person who signs the child in/out of the facility shall use their full legal signature and record the time of day.  All children are under supervision, including visual supervision, of a teacher at all times.  Facility maintains a ratio of one teacher supervising no more than 12 children in care.  LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment.  LPA reviewed a sample of staff files and observed files were complete with health screening, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training.  Menus are posted at least one week in advance where an authorized representative can view them.

Facility representative 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.

This facility does not provide Incidental Medical Services (IMS) at this time. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services.  IMS Plan is posted in classrooms. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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: ST. ROSE OF LIMA PRE-SCHOOL
FACILITY NUMBER: 376700733
VISIT DATE: 03/02/2023
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LPA and discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, California Megan’s Law (www.meganslaw.ca.gov), Lead Poisoning Facts, Forms and Regulations.


No deficiencies cited.

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/‌inspection-process.

A copy of the report and appeal rights (LIC 9058) was provided to the Director and notice of site visit (LIC9213) was given to Director and must remain posted for 30 days.

An exit interview conducted and report was reviewed with the facility representative, Neisy Ibanez.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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