376701061-5-25-2023-51-CC-KLAE-CS723N-20230525170238

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701061
Report Date: 05/25/2023
Date Signed: 05/25/2023 05:02:46 PM

Document Has Been Signed on 05/25/2023 05:02 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:	VINE LEARNING CENTER, THE		FACILITY NUMBER:	376701061
ADMINISTRATOR:	ANA LOPEZ		FACILITY TYPE:	850
ADDRESS:	2130 ULRIC STREET		TELEPHONE:	(858) 974-1222
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92111
CAPACITY:	108	CENSUS: 92	DATE:	05/25/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	04:20 PM
MET WITH:	Ana Lopez		TIME COMPLETED:	05:15 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 5/25/23 at 4:20 PM, Licensing Program Analysts (LPAs) Keturah Lane and Gerald Poindexter conducted an unannounced case management visit to follow up on an unusual incident that was reported 12/14/22. Upon arrival, LPAs met with facility representative Director Ana Lopez and toured the facility. Census was as follows: Classroom Monkeys: 22 children with staff members: Elizabeth Carpio and Ebone Singleton (11 children were inside & 11 children were outside on playground) Classroom Ladybugs: 21 children with staff members: Amber Mallobox-MacCartee and Estrella Andrade Classroom Bumblebees: 22 children with staff members: Maria Cabrera and Maria Ossmen-Conway Butterflies: 16 children with staff members Daniela Navarrete and Briana Gomez Classroom Dragonflies: 11 children with staff member Martha Villalba (Ms. Patty) (continued on LIC9099-C...) The incident reported involved a child (C2) that was injured on the playground and received medical treatment for the injuries sustained. C2 fell to the ground and was injured when another child was jumping on C2's arm, causing a serious injury and medical treatment. Staff were not aware what happened until another child informed them what they observed. Based upon LPAs observations of the playground area, interviews conducted with staff members, enrolled children and parents of enrolled children it was found that staff member (S1) was helping children in the bathroom and staff member (S2) was on the other side of the playground. They were unable to maintain visual observation of the children from where they were. Due to lack of supervision by staff members, neither staff member saw exactly how child was injured. Additional staff are needed for supervision on the playground when a staff member needs to assist children in the bathroom.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

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: VINE LEARNING CENTER, THE	FACILITY NUMBER: 376701061
	VISIT DATE: 05/25/2023

NARRATIVE

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Pursuant to Title 22 of the CA Code of Regulations, the following Type A deficiency was cited (refer to LIC809-D). This is a repeat violation.

LPA Keturah Lane informed facility representative Director Ana Lopez that this report dated 5/25/23 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Keturah Lane informed the facility representative to provide a copy of this licensing report dated 5/25/23 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Civil penalties were assessed in the amount of $250. Facility representative was provided a copy of the Civil Penalties Assessment LIC421FC.

Exit interview conducted and report was reviewed with facility representative Director Ana Lopez. Notice of site was provided and must remain posted for 30 days.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/25/2023 05:02 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: VINE LEARNING CENTER, THE	FACILITY NUMBER: 376701061
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/25/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/26/2023 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229(a)(1) Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children’s needs. (1) No child(ren) shall be left without the supervision of a teacher at any time…Supervision shall include visual observation. This requirement was not met as evidenced by…	1 2 3 4 5 6 7	Director stated they will have extra staff available to help with potty-training and bathroom assistance so that adequate supervision and visual observation is maintained at all times when children are also on the playground area. Staff will receive training notifying them of the additional staff requirement and to request additional staff when needed to maintain proper supervision. Director will send written plan of correction with staff sign-in sheets acknowledging staff training.
	8 9 10 11 12 13 14	Based upon LPAs observations and interviews with staff members, children and parents of enrolled children, licensee did not ensure staff supervision including visual observation because staff member was helping children in the bathroom which resulted in child’s injury requiring medical treatment and is an immediate health, safety and personal rights risk to children in care. This is a repeat violation. Civil penalties assessed.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah Lane	TELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

LIC809 (FAS) - (06/04)

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