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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700775
Report Date: 11/07/2022
Date Signed: 11/07/2022 02:26:05 PM


Document Has Been Signed on 11/07/2022 02:26 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:MAAC PROJECT HEAD START CARLSBAD 1 - EUREKA PLACEFACILITY NUMBER:
376700775
ADMINISTRATOR:JACQUELYN BISKUPSKIFACILITY TYPE:
850
ADDRESS:3368 EUREKA PLACETELEPHONE:
(760) 720-4378
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY:82CENSUS: 34DATE:
11/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Jacquelyn BiskupskiTIME COMPLETED:
12:30 PM
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On 11/07/2022 at 10:50AM, Licensing Program Analyst (LPA) Samantha Clenista visited the facility to conduct an annual inspection. Upon arrival LPA met with facility representative Director, Jacquelyn Biskupski, and proceeded to tour the facility. During today's inspection, there were 34 children with 7 staff members in 3 classrooms. Appropriate ratios and capacity were observed. Appropriate care & visual supervision were also observed during the inspection.

Furniture and age appropriate equipment is in good condition. Rooms have adequate heating, lighting, ventilation. Floors appear to be clean and safe. Bathrooms are maintained with operational toilets and sink faucets with appropriate temperature. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. Food service area consists of a kitchen which is clean and free of hazards. Menu is posted. Adequate food is available for snacks and lunches. Cleaning supplies are kept separate from food and are inaccessible to children. Storage containers for solid waste have tight-fitting covers and are kept in good repair. Director stated there are no firearms or other weapons on the premises. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 F or less. The facility appears to be free of insects and rodents. There is an operational carbon monoxide detector at the facility located in each classroom.

Outdoor play area is a fenced playground with sufficient material for cushioning. There are no bodies of water at this facility during time of inspection. All wading pools or similar product must be emptied immediately after use and stored in an upright position. Climbing structures and slides are securely fixed to the ground. Area has large canopies/sails and trees used for shade. Facility currently has water available to the children inside and outside via water cups and refillable water jugs. Last conducted and documented fire drill was on 10/12/2022.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha ClenistaTELEPHONE: (619) 818-6740
LICENSING EVALUATOR SIGNATURE:
DATE: 11/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/07/2022
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: MAAC PROJECT HEAD START CARLSBAD 1 - EUREKA PLACE
FACILITY NUMBER: 376700775
VISIT DATE: 11/07/2022
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LPA reviewed medication storage. Personnel records contain health screening documentation and at least one staff member has current CPR and First Aid certifications. All staff have completed mandated reporter training per AB1207. Required immunization's for all staff files that were reviewed was observed in compliance. Each personnel record contains documentation of educational background and training. Sign ins were reviewed. Children’s records contain admission agreements and medical assessment. 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.

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.

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 provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

Exit interview conducted and report was reviewed with facility representative Director. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha ClenistaTELEPHONE: (619) 818-6740
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2022
LIC809 (FAS) - (06/04)
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