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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700867
Report Date: 10/19/2020
Date Signed: 10/19/2020 11:57:02 AM

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:RISE N SHINEFACILITY NUMBER:
376700867
ADMINISTRATOR:MYMIONA JOHNSONFACILITY TYPE:
850
ADDRESS:9449 WINTER GARDENS BOULEVARDTELEPHONE:
(619) 390-0200
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY:37CENSUS: 15DATE:
10/19/2020
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Christina BaxterTIME COMPLETED:
12:00 PM
NARRATIVE
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On October 19, 2020 at 12:00PM Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced case management tele-inspection via Facetime. This inspection was conducted via Facetime due to COVID-19 pandemic restrictions. Observed present today were 15 children in the following rooms:

Toddlers (2-3 y.o.) with 3 children and staff Hadeel Teimoor
Toddler Option (18 mos - 2) with 5 children and staff Cassie Rhoton
Preschool (3-5 y.o.) with 7 children and staff Rachel Cox

The purpose of this inspection was to deliver the citation to a deficiency observed during a complaint tele-inspection conducted on 9/25/2020. During this tele-inspection, LPA Nancy Diaz observed Stormy Jackson supervising 4 school-age children. Ms. Jackson's fingerprint clearance is not associated to this facility. LPA conducted a file review and it revealed that Ms. Jackson was disassociated from the preschool license on October 2, 2019.

Type B deficiency was cited. Civil penalty was assessed.

Type B violation if not corrected, is a potential risk to the health, safety, or personal rights of children in care.

See deficiency cited on the attached LIC 809D.

A copy of this report was emailed to christina_bell94@ymail.com (acting director's email address) at the conclusion of the inspection. LPA requested that a signed report be submitted to this analyst within 24 hours of receipt to nancy.diaz@dss.ca.gov.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2020
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: RISE N SHINE
FACILITY NUMBER: 376700867
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/15/2020
Section Cited

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CRIMINAL RECORD CLEARANCE.
All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility...Request a transfer of a criminal record clearance as specified in Section 101170(f)... clearance...
This requirement was not met as evidenced by LPA's review of Staff fingerprint clearance association list. Stormy Jackson's fingerprint clearance is not associated to the facility.

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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: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
LICENSING EVALUATOR SIGNATURE:
DATE: 10/15/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/15/2020
LIC809 (FAS) - (06/04)
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