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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701061
Report Date: 05/03/2024
Date Signed: 05/03/2024 03:20:15 PM


Document Has Been Signed on 05/03/2024 03:20 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:VINE LEARNING CENTER, THEFACILITY NUMBER:
376701061
ADMINISTRATOR:ANA LOPEZFACILITY TYPE:
850
ADDRESS:2130 ULRIC STREETTELEPHONE:
(858) 974-1222
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY:108CENSUS: 81DATE:
05/03/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Anna LopezTIME COMPLETED:
03:30 PM
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On 5/3/24 at 1:30 pm, Licensing Program Analyst, Gerald Poindexter, made an unannounced visit to follow up on a self-reported incident that occurred approximately 10:30 am on Friday, 3/22/24 wherein Child #1 (C1) of the Ladybugs Group fell in the Ladybugs Playground, sustaining an injury. The incident was self-reported to Community Care Licensing by the facility with a written incident report that was received within the seven days requirement on 03/26/2024. Facility operates Monday-Friday, 6:30 am to 5:30 pm.
Present at the facility were 81 daycare children and 10 staff across 5 classrooms. Facility is within ratio and capacity.

LPA met with center director Ana Lopez. Based upon information obtained, the child was running from one end of the play area to the opposite end. The child stumbled over their own feet, fell, and sustained the injury. Staff #1 (S1) and #2 (S2) observed the fall but were unable to intervene. S2 attended to the child, providing an ice pack to prevent swelling. Staff #3 (S3) called the child’s mother.

LPA examined the area of the 3/22/24 incident and inspected the play equipment. LPA observed that Ladybugs Playground is primarily covered by a padded, green turf surface that is bordered by concrete. The turf surface, from end to end displays no damaged materials or obvious tripping hazards. It supports age-appropriate equipment. LPA advised the director to be wary of any higher traffic sections of the turf that may become worn.

Director Lopez verified the staff/child ratios at the time of the incident: 2 staff members with 19 children present. The extent of the injury was not immediately apparent, but later the child’s mother confirmed that the C1 had sustained a broken elbow requiring surgery. According to Director Lopez, the parent of C1 has discussed the incident with facility leadership. There are no ongoing physical complications and the child was back attending the facility on Monday, 3/25/24.


CONTINUED ON PAGE 2
SUPERVISOR'S NAME: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: VINE LEARNING CENTER, THE
FACILITY NUMBER: 376701061
VISIT DATE: 05/03/2024
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Director Lopez states that following the incident, the facility’s playground protocols were reviewed with the teachers present. The director stated that neither S1 nor S2 is currently associated with the facility (for reasons unrelated to the incident).

No deficiencies are cited.

Exit interview conducted with the center director, Ana Lopez. Notice of site visit was given and it must remain posted for 30 days.
SUPERVISOR'S NAME: Joelle ReddingTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Gerald PoindexterTELEPHONE: 619-767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
LIC809 (FAS) - (06/04)
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