376701160-9-3-2019-51-CC-ACAN-BFNSE3-20190903134801

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701160
Report Date: 09/03/2019
Date Signed: 09/03/2019 01:48:07 PM

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:	KRISSI BITTNER GODINEZ		FACILITY TYPE:	850
ADDRESS:	10830 CALLE MAR DE MARIPOSA		TELEPHONE:	(858) 793-0071
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92130
CAPACITY:	67	CENSUS:	DATE:	09/03/2019
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Bridgette Blazy		TIME COMPLETED:	01:30 PM

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	Licensing Program Analyst Adrian Castellon made an unannounced case management visit to follow up on a self reported incident that occurred on 8.19.19 wherein a child in care (Child #1) left the classroom without the knowledge of facility staff. LPA Castellon spoke with facility staff present on the date of the incident. LPA Castellon also spoke with site supervisor Krissi Bittner-Godinez and Program Director Brigitte Blazys and evaluated the area where the incident took place. LPA Castellon attempted to interview child #1 and took pictures of the facility. Child #1 left the classroom as he was following his mother out of the classroom after being dropped off for his first day of school. It was the first day for the licensed program, but the rest of the elementary school did not start school until a week later. There were 10-12 students present on the day and time of the incident. Two staff members were present. The child exited a "back door" of the classroom and then a school gate. The child was located approximately 5 feet from the main gate exit, which is approximately 10 feet from the classroom door. The main gate exit leads directly into a parking lot. A possible school parent found the child outside of the school gates and flagged a school staff member down to report. The staff member returned the child to his assigned classroom. Teacher immediately notified supervisor and parent of child was advised. Mother asked about the child's well being. Child was not harmed. Mother of child arrived at normal pick up time and the incident was again discussed. Child was unaccounted for approximately 2-5 minutes. Child left classroom and exited main gate onto the sidewalk adjacent to the parking lot. Based on the information gathered by LPA Castellon and the staff's own admission, a licensing violation occurred and a type A citation will be issued. Please see LIC809D for citation and plan of correction. Notice of site visit and copy of report must be posted for 30 days. LPA Castellon discussed LIC9224 and reporting requirements.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: 619-767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

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 2

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: DMUSD EARLY CHILDHOOD DEVELOPMENT CENTER(ECDC)	FACILITY NUMBER: 376701160
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/03/2019 Section Cited	1 2 3 4 5 6 7	101229(a)(1) Responsibility for Providing Care and Supervision: (a) The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1).
	8 9 10 11 12 13 14	Supervision shall include visual observation. The regulation was violated as evidenced by the fact that child #1 in care left the classroom for approximately 2-5 minutes without the knowledge of facility staff. This is an immediate danger to children in care.	8 9 10 11 12 13 14	A sign has been posted so that parents and staff are aware to only use the main door of the classroom.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: 619-767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2