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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701135
Report Date: 01/13/2022
Date Signed: 01/14/2022 10:44:52 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:CORONADO BAPTIST INFANT CAREFACILITY NUMBER:
376701135
ADMINISTRATOR:PRYSOCK, MARTHAFACILITY TYPE:
830
ADDRESS:111 ORANGE AVENUETELEPHONE:
(619) 435-8121
CITY:CORONADOSTATE: CAZIP CODE:
92118
CAPACITY:24CENSUS: 12DATE:
01/13/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:John RoamerTIME COMPLETED:
03:40 PM
NARRATIVE
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On 1/13/2021 at 12:15 p.m., Licensing Program Analysts (LPA), Adrian Castellon and Crystal Tillory arrived to conduct an unannounced Plan of Correction (POC) inspection for deficiencies cited on 11/10/2021 for the preschool license. Upon arrival, LPA met with director Martha Prysock and toured the facility. Pastor Roamer arrived approximately one hour after LPA arrival.

During the inspection, LPAs were advised of a staff covid positive that was not properly reported to the licensing office. The covid positive occurred in the infant license. This report will be used to memorialize the citation. A Type B citation will be issued on this date. Please see LIC809D.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022
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: CORONADO BAPTIST INFANT CARE
FACILITY NUMBER: 376701135
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/13/2022
Section Cited

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101212(d)(1)(C): Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be
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submitted to the Department within seven days following the occurrence of such event. This requirement was not met as evidenced by: staff member tested positive for covid-19 and the facility failed to report the incident in a timely manner which 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: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:
DATE: 01/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/13/2022
LIC809 (FAS) - (06/04)
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