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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701152
Report Date: 03/10/2020
Date Signed: 03/10/2020 11:01:34 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:APPLE YOUCHIENFACILITY NUMBER:
376701152
ADMINISTRATOR:ONO, YUKIKOFACILITY TYPE:
850
ADDRESS:2550 FAIRFIELD STREETTELEPHONE:
(619) 994-0620
CITY:SAN DIEGOSTATE: CAZIP CODE:
92110
CAPACITY:30CENSUS: 13DATE:
03/10/2020
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Yukiko OnoTIME COMPLETED:
11:15 AM
NARRATIVE
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On 03/10/2020 at 9:20AM, Licensing Program Analyst (LPA) Elise Read and Office Technician (OT) Tiffanie Diep conducted an unannounced Case Management inspection in regards to the Non-Compliance Conference (NCC) that was held on 07/24/2018. LPA was greeted and granted entry by staff member Natsuko Lauritzen. Director Yukiko Ono arrived and completed inspection with LPA Read.

LPA reviewed the hours of operation with the Licensee. Preschool children are present Monday-Friday from 9am-4:30pm, though most children leave at 2pm. School-age children are present Wednesday and Thursday from 2pm-6:30pm, though most school-age children leave by 6pm.

Facility has completed Self Assessment Guides per the NCC on 07/24/2018. Director provided the Self Assessment Guides to LPA Read to review during inspection.

Upon inspection, LPA Read observed multiple cleaning products and hazards that were accessible to children. In the children's bathroom, LPA Read observed a cabinet that was unlocked which contained Lysol spray, Clorox wipes, and hand sanitizer. On the counter accessible to children in the classroom was Clorox wipes and hand sanitizer, as well. LPA also observed adult scissors in a bottom drawer for children, as well as on a shelf accessible to the preschool children. Director immediately removed the products from reach and placed in locked cabinet.

LPA also recommended to Director that cleaning supplies not be stored in the children's bathroom. Director stated that the items will be moved to another locked cabinet .
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Elise ReadTELEPHONE: (619) 767-2240
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: APPLE YOUCHIEN
FACILITY NUMBER: 376701152
VISIT DATE: 03/10/2020
NARRATIVE
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LPA Read obtained updated LIC 500 during today's inspection.

See LIC 809D for cited deficiencies.

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

Upon Receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/Guardians will sign the LIC 9224 upon receipt of the licensing report and this will be kept in each child’s file. 

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: Elise ReadTELEPHONE: (619) 767-2240
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: APPLE YOUCHIEN
FACILITY NUMBER: 376701152
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/10/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/10/2020
Section Cited

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Buildings and Grounds- Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement was not met as evidenced by:
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Based on LPA's observation, licensee did not ensure that all items that could pose danger to children were properly stored, which poses an immediate Health and Safety risk to children in care.
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areas securely inaccessible to children at all times.

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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: Elise ReadTELEPHONE: (619) 767-2240
LICENSING EVALUATOR SIGNATURE:
DATE: 03/10/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/10/2020
LIC809 (FAS) - (06/04)
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