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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701141
Report Date: 02/26/2020
Date Signed: 02/26/2020 11:36:30 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:ABC CHILDREN'S CENTER AT SAN DIEGO-INFANTFACILITY NUMBER:
376701141
ADMINISTRATOR:WELTY-HAZIM, NICOLEFACILITY TYPE:
830
ADDRESS:12145 ALTA CARMEL CT. #270TELEPHONE:
(858) 451-1663
CITY:SAN DIEGOSTATE: CAZIP CODE:
92128
CAPACITY:20CENSUS: 10DATE:
02/26/2020
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
07:30 AM
MET WITH:Nicole Welty-Hazim, Pooja Sharma/AdministratorTIME COMPLETED:
11:40 AM
NARRATIVE
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Licensing Program Analyst, Selina Siao conducted an unannounced inspection today. During today's inspection, LPA observed the facility to be out of ratio by having 5 infants in the younger infant classrooms supervised by teacher Veronica Rivera starting at 7:37am. In the older infant classroom teacher Tina Mazdeh had 5 infants at 7:45am. The third infant teacher Shanna Tanner arrived at the facility at 7:47am and brought the facility in ratio. Analyst observed the facility to be out of ratio for approximately 10 minutes today.

All staff members have the required background clearances and are associated to the facility.

See LIC809D for citation issued:



Appeal Rights (1/16) were discussed and provided. Signature at the bottom of this report confirms receipt. Notice of Site Visit was posted during this visit and will remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
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: ABC CHILDREN'S CENTER AT SAN DIEGO-INFANT
FACILITY NUMBER: 376701141
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/02/2020
Section Cited

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Staff-Infant Ratio 101416.5(b)
There shall be a ratio of one teacher for every four infants in attendance. This requirement was not met as evidenced by:
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Analyst observed both infant classrooms to have 5 infants supservised by one teacher for approximately 10 minutes. This poses a potential health and safety risk to clients in care
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Director will submit a writtten plan of correction to Analyst along with an updated personnel report LIC500 to Analyst by 03/02/2020.

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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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2020
LIC809 (FAS) - (06/04)
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