<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700797
Report Date: 03/04/2020
Date Signed: 03/04/2020 12:48:43 PM

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:MISSION HILLS CHURCH PRESCHOOLFACILITY NUMBER:
376700797
ADMINISTRATOR:WINKLER, ANGELAFACILITY TYPE:
850
ADDRESS:400 MISSION HILLS COURTTELEPHONE:
(760) 759-2164
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:100CENSUS: 92DATE:
03/04/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Louisa AguilarTIME COMPLETED:
01:00 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 March 4, 2020 at 8:50 a.m. Licensing Program Analyst (LPA) Leilani Curtis and Licensing Program Managers Monica Cuddy and Tashima Daniel visited the facility for the purpose of conducting an annual inspection. Upon arrival LPA and LPM’s met with Director Louisa Aguilar and proceeded to tour the facility. Also present were a total of 92 children in the following classrooms:
  • Classroom #110: 17 children with staff Peyton Johnson and Cassandra Jackson
  • Classroom #109: 17 children with staff Shelly Katje and Renee Harrell
  • Classroom #108: 15 children with staff Alieda Denboer and Rebecca Crook
  • Classroom #107: 13 children with staff Michelle Stires and Ashlee Williams (Bedke)
  • Classroom #106: 14 children with staff Darlene Gonzales and Ruth East
  • Club House: 16 children with staff Stacy Jackson and Antoinette Smiley

Appropriate ratios and capacity were observed. Furniture and age appropriate equipment is in good condition indoors and outdoors. Children's toilets and hand washing facilities are sanitary. Rooms are safe and clean. Food preparation area is clean, food and beverages are stored in covered containers at 45 degrees F or less if required, and storage containers for solid waste are covered. Drinking water is readily accessible inside and outside the classroom. All disinfectants, cleaning solutions, and other hazardous items are inaccessible to children through latches and locks. Storage area for poisons is locked. Outdoor play area is fenced with adequate material for cushioning. The area has canopies used for shade. There are no bodies of water or weapons at this facility. No excluded individuals are present. Fire drills are being conducted every 6 months. There is an operational carbon monoxide detector at the facility. First Aid/CPR certifications were reviewed and in compliance. Staff members have completed the Mandated Child Abuse Reporting-per AB1207. LPA reviewed certifications and they are also in compliance.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
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 3
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: MISSION HILLS CHURCH PRESCHOOL
FACILITY NUMBER: 376700797
VISIT DATE: 03/04/2020
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
26
27
28
29
30
31
32
 Immunization records were reviewed. Staff member Ashlee Williams did not have verification of measles immunization on site and staff member Renee Harrell did not have immunization records for measles or pertussis available for review. Sign in/sign out sheets are well maintained. Admission Agreement forms reviewed for some children. Staff records contain documentation of education, training, and/or experience. Menus are posted.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication as well as equipment/supplies. An Epi-Pen for one child expired on 1/15/20. Children’s, personnel, and administrative records were reviewed. 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.

LPA provided the most recent PINS to Director Louisa Aguilar. LPA obtained updated LIC 500, LIC 610 and Children's Roster. The Director will send an updated LIC 309 to LPA by 3/18/20. Facility representatives were advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information.

See LIC809D for cited deficiencies. The Director was provided a copy of their appeal rights (LIC 9058 01/16) and her signature on this form acknowledges receipt of these rights. NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS. LPA observed Director post notice of site visit.

Duty Line was provided: (619) 767-2248.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: MISSION HILLS CHURCH PRESCHOOL
FACILITY NUMBER: 376700797
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/04/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/18/2020
Section Cited

1
2
3
4
5
6
7
101226(e)(3)(A) Health-Related Services: (e)In centers where the licensee chooses to handle medications:(3) Prescription medications may be administered if all of the following conditions are met:(A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician. This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on LPA's observations staff did not ensure that child #1's medication was current and not expired. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Type B
03/18/2020
Section Cited

1
2
3
4
5
6
7
1596.7995(c) Employees or volunteers at day care center; immunization requirements; records; exemptions: The day care center shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the day care center. This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on LPA's facility record review, verification of measles immunization is missing for Ashlee Williams and verification of measles and pertussis immunization is missing for Renee Harrell. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
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: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 03/04/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/04/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3