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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700770
Report Date: 08/31/2023
Date Signed: 08/31/2023 01:32:05 PM


Document Has Been Signed on 08/31/2023 01:32 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:MAAC PROJECT HEAD START ESCONDIDO 3 - HICKORYFACILITY NUMBER:
376700770
ADMINISTRATOR:MARROU, JACQUELINFACILITY TYPE:
850
ADDRESS:635 N. HICKORY STREETTELEPHONE:
(760) 419-8623
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:60CENSUS: 8DATE:
08/31/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:08 PM
MET WITH:Jacquelin MarrouTIME COMPLETED:
02:00 PM
NARRATIVE
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On August 31, 2023, at 01:08 PM Licensing Program Analyst (LPA), Courtnee Peebles met with MAAC PROJECT HEAD START ESCONDIDO 3 - HICKORY (CCC), Director, Jacquelin Marrou to discuss an unusual incident that was reported to Community Care Licensing (CCL).

The Department was made aware of the incident of a child being left unattened while the teachers and all other students were on the playground. LPA informed Ms. Marrou that appropriate supervision must be provided at all times to children in care and all unusual incidents must be reported to the department within 24 hours through the Duty line and a written report must be submitted within 7 days.

The facility is being cited for Title 22 Regulation Section 101229(a)(1) Responsibility for Providing Care and Supervision

(a) The licensee shall provide care and supervision as necessary to meet the children’s needs.

(1) No child(ren) shall be left without the supervision of a teacher at any time, …… Supervision shall include visual observation.

An exit interview was conducted, and a copy of this report was provided to Director Jacquelin Marrou.

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

SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Courtnee PeeblesTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 08/31/2023 01:32 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501


FACILITY NAME: MAAC PROJECT HEAD START ESCONDIDO 3 - HICKORY
FACILITY NUMBER: 376700770

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/01/2023
Section Cited
HSC
101229(a)(1)

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101229(a)(1) Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children’s needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, …… Supervision shall include visual observation. This requirement was not met as evidenced by:
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The director has since implented new policies when transitioning the children. The third teacher that is present will not take a break until the transition has been made. As well as when the children are walking out they are to high five the teacher on the way out ensuring all children are present as they do a head count of the children,
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Based on interviews, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
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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: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Courtnee PeeblesTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2