<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701160
Report Date: 03/06/2020
Date Signed: 03/06/2020 11:41:50 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:DMUSD EARLY CHILDHOOD DEVELOPMENT CENTER(ECDC)FACILITY NUMBER:
376701160
ADMINISTRATOR:JULIE NGUYENFACILITY TYPE:
850
ADDRESS:10830 CALLE MAR DE MARIPOSATELEPHONE:
(858) 793-0071
CITY:SAN DIEGOSTATE: CAZIP CODE:
92130
CAPACITY:67CENSUS: DATE:
03/06/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Director Julie NguyenTIME COMPLETED:
11:50 AM
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 3/6/2020 at 10:55 a.m., Licensing Program Analyst, Joelle Redding, made an unannounced visit to follow up on a self-reported incident that occurred on 2/24/2020 wherein a 5 year old child (Child #1) fell from a balance beam, sustaining a fractured elbow.

LPA spoke with Staff #1 who responded to Child #1 when she fell. She stated that she did not see the fall, but knows that Child #1 had just finished snack and headed over the the balance beam. There were no other children around Child #1 at the time. Staff #1 stated that she saw Child #1 get up and hold her arm close to her. Staff #1 told her not to move her arm, called for the Director, applied ice in the meantime and the Director then transported Child #1 to the school nurse's office for further evaluation. LPA spoke with Staff #2 who witnessed the fall. She stated that Child #1 had just gotten on to the beam and was stepping from one block to the other. Child #1 stepped on the edge of the block and it tipped, causing her to lose her balance. Staff #2 stated that Child #1 put her arm out to brace her fall and stated that as she fell, it just looked "wrong." Staff #2 noted that Staff #1 responded, obtained ice for the child and confirmed Staff #1's statement that the Director was contacted and Child #1 was transported to the school nurse's office. LPA spoke with Child #1 who described the event just as the staff related it. Child #1 was subsequently picked up and transported to the doctor where she was diagnosed with a fractured elbow.

LPA evaluated the grassy area where the incident occurred. It is just beside the snack tables outside the classrooms. The balance beam blocks are plastic, connected with a rope and approximately 5" high. They are age appropriate. There were 45 children with five teachers at the time. Supervision was in place and ratios were met when the incident occurred. No unsafe behavior contributed to the incident and the equipment used is age appropriate. The grass provided cushioning around the balance beam. The facility responded to the incident appropriately and reported timely.

No deficiencies are cited.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2020
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 1