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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700908
Report Date: 09/15/2021
Date Signed: 09/15/2021 03:20:51 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:PACIFIC PRESCHOOL - SAN ELIJO HILLS, INCFACILITY NUMBER:
376700908
ADMINISTRATOR:EMILY BIGGERSFACILITY TYPE:
850
ADDRESS:1301 ELFIN FOREST ROAD WESTTELEPHONE:
(760) 510-0155
CITY:SAN MARCOSSTATE: CAZIP CODE:
92078
CAPACITY:130CENSUS: 73DATE:
09/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Emily BiggersTIME COMPLETED:
03:30 PM
NARRATIVE
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On 9/15/2021 at 9:55 a.m. Licensing Program Analyst (LPA) Leilani Curtis visited the facility to conduct an annual inspection. Upon arrival LPA met with Director Emily Biggers and proceeded to tour the facility. Also present were a total of 73 children with 14 staff members in the following classrooms:

Classroom 1: 13 children with staff Judith Tribbey and Nora Macedo
Classroom 2: 10 children with staff Lizeth Gomez and Karin Dunn
Classroom 3: 11 children with staff Alexus Price and Amy McCurry
Classroom 4: 8 children with staff Vicki Benavides and Jesenia Carrasco
Classroom 5: 14 children with staff Elisa Casillas and Cynthia Harvey
Classroom 6: 8 children with staff Jaeyoen Yoon and Myla Stephenson
Classroom 7: 9 children with staff Teresa Armstrong
Outside Playground Floater: Evagalenie Blomgren

Appropriate ratios and capacity were observed. Staff members have the required background clearances. Two staff members, S1 and S2 have the required background clearances but are not associated to the facility. No excluded individuals are present. 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. The director states that the facility does not provide food or snack to the children. 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. Medications are kept in a safe place inaccessible to children. The outdoor play area is fenced. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The areas around or under high climbing equipment, swings, slides, and similar equipment is cushioned with material that absorbs a fall. The outdoor play area has canopies used for shade.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
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: PACIFIC PRESCHOOL - SAN ELIJO HILLS, INC
FACILITY NUMBER: 376700908
VISIT DATE: 09/15/2021
NARRATIVE
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There are no bodies of water or weapons at this facility. Fire drills are being conducted every 6 months. There are multiple carbon monoxide detectors at the facility. Each carbon monoxide detector had a green light indicating that it is operational. LPA and Director were unable to activate an audible alarm. First Aid/CPR certifications were reviewed and are in compliance. 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. Of the 14 staff files reviewed two staff members (S3 and S4) did not have current Mandated Reporter Certificates.

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.

LPA reviewed the following with Director Biggers: Updated Coronavirus 2019 Industry Guidance for Child Care Settings PIN 21-18-CCP and California Department of Public Health Child Care Industry Guidance updated June 29, 2021. LPA obtained an updated Emergency Disaster Plan for Child Care Centers- LIC610A, Personnel Report-LIC500, a copy of fire drill log and Parent Handbook.



See LIC809D for cited deficiencies.

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. Duty Line was provided: (619) 767-2248. LPA also discussed California Megan's Law and LPA provided Director with the following website: www.meganslaw.ca.gov

An exit interview was conducted with the Director and Appeal Rights (LIC 9058 1/16) were discussed. The director’s signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed the director post notice of site visit.

SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
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: PACIFIC PRESCHOOL - SAN ELIJO HILLS, INC
FACILITY NUMBER: 376700908
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2021
Section Cited

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Criminal Record Clearance: (e) All individuals subject to a criminal record review...shall prior to working, residing or volunteering in a licensed facility(2) Request a transfer of a criminal record clearance as specified in Section 101170(f)...This requirement was not met as evidenced by:
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Based on LPA's record review S1 and S2 are fingerprint cleared but not associated to the facility. This poses a potential health and safety risk to children in care.
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Type B
09/29/2021
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years...This requirement was not met as evidenced by:
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Based on LPA's record review two staff members (S3 and S4) did not have current Mandated Reporter certifications in file. This poses a potential health and safety risk to children 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: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2021
LIC809 (FAS) - (06/04)
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