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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700939
Report Date: 02/27/2023
Date Signed: 02/27/2023 03:00:09 PM


Document Has Been Signed on 02/27/2023 03:00 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:CAMBRIDGE SCHOOL, THEFACILITY NUMBER:
376700939
ADMINISTRATOR:ALYSSA LEEFACILITY TYPE:
850
ADDRESS:12855 BLACK MOUNTAIN ROADTELEPHONE:
(858) 484-3488
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY:16CENSUS: 15DATE:
02/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Director Alyssa LeeTIME COMPLETED:
03:10 PM
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On 2/27/2023 at 1:00 p.m., Licensing Program Analyst (LPA), Joelle Redding, met with Director Alyssa Lee, for the purpose of an unannounced annual inspection. There were 15 children present with the Director (who also acts as a Aide to the lead), Lead Teacher and an assistant in Room 101. Facility is within ratio and capacity.

LPA toured the facility. The room was clean, orderly and a comfortable temperature during this visit. Adequate ventilation and heating are available. The furniture, books, games and toys are safe, age-appropriate and in good repair. There are a variety of activities available throughout the day. All required forms were posted. All storage containers and trashes containing solid waste have tight fitting lids and are in good repair. Children bring their own snacks and lunches. Emergency snack is on hand, stored per regulation and of good quality and quantity. Napping equipment is sufficient for each child, bedding is stored separately, and cots are disinfected after use. Facility has ensured that there is adequate space between cots for easy passage and they are not blocking entrances or exits. Hand washing and toileting areas are in a safe, sanitary and operating condition. There is an approved waiver to share the outdoor bathrooms. Any waste water used to clean is being discarded after use. Medications are kept in an emergency backpack in the classroom, inaccessible to children. Poisons, disinfectants, cleaning solutions and other items that are dangerous to children have been made inaccessible. There is no evidence of rodent or insect activity. Outdoor play area is fully fenced with sufficient cushioning and adequate shade. There is an approved waiver on site to share the playground wit the private school on a scheduled basis (9/9/2015). There is a play structure labeled 5 to 12 years that was previously approved to use a portion of that is applicable to the 4 to K age range. Director stated the no ladders are used and the monkeys bars are off limits as are the higher portions of the structure. A revised waiver request from last year's visit on 5/11/22, will be sent. Outdoor surfaces are in a safe condition with any equipment securely bolted to the ground. Portable water is used outdoors. There are no bodies of water, firearms or ammunition on the property. The carbon monoxide
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
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: CAMBRIDGE SCHOOL, THE
FACILITY NUMBER: 376700939
VISIT DATE: 02/27/2023
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detector is operational. The facility has a written disaster plan in place that meets regulatory requirement and has been conducting and documenting evacuation drills every six months. (2/7/23). The facility does not transport children.

LPA reviewed sign in/out sheets, a sample of personnel records and a sample of children's records. There is at least one staff present with current CPR and First Aid certification. Facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com.

Children are evaluated upon entry and monitored throughout the day for signs of illness. The isolation area for ill children awaiting pick up is the school nurse's office. Reporting requirements for positive Covid-19 results in children or staff were discussed to include contact with County Department of Public Health for guidance (619-692-8499) and Licensing (619-767-2248) to report the unusual incident for two or more cases.

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 . Services are in place today.

Director 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.

Director is signed up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov.


SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 02/27/2023 03:00 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: CAMBRIDGE SCHOOL, THE
FACILITY NUMBER: 376700939

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above in that Staff #1, 3 and 4 did not have proof of immunity to Pertussis, Measles and Influenza on file which poses a potential health, safety or personal rights risk to children in care.
POC Due Date: 03/27/2023
Plan of Correction
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Director states that she will ensure all staff have the required immunization information on file by the plan of correction date and will send proof of correction to Licensing via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4


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: CAMBRIDGE SCHOOL, THE
FACILITY NUMBER: 376700939
VISIT DATE: 02/27/2023
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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/process

LPA conducted child care quality management interview with Director Alyssa Lee. Exit interview conducted and report was reviewed with the Director.

See LIC 809D.

NOTICE OF SITE VISIT WAS GIVEN AND WILL REMAIN

SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4