376701190-6-2-2022-51-CC-SCLA-CEZV2X-20220602160352

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701190
Report Date: 06/02/2022
Date Signed: 06/02/2022 04:04:26 PM

Document Has Been Signed on 06/02/2022 04:04 PM - It Cannot Be Edited

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:	CARLSBAD EDUCATIONAL FOUNDATION - VALLEY MIDDLE		FACILITY NUMBER:	376701190
ADMINISTRATOR:	MAYA SHROPSHIRE		FACILITY TYPE:	840
ADDRESS:	1645 MAGNOLIA AVENUE		TELEPHONE:	(760) 929-1555
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92008
CAPACITY:	30	CENSUS: 0	DATE:	06/02/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	April Smith		TIME COMPLETED:	03:15 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	On 06/02/2022 at 2pm, Licensing Program Analyst (LPA) Samantha Clenista conducted an unannounced case management site inspection. Upon arrival, LPA met with April Smith, Area Manager. This facility requested an increase of capacity from having 30 children to 280 children. The program requested to operate in the following rooms: 601, 602, 603, 604, 606, 701, 702, 705, 706, 707, Fitness Lab and Multi-Purpose Room (aka gym). Fire clearance was granted on 06/01/2022. There were no children present during inspection. All above classrooms were inspected during this visit. During the inspection, the above classrooms were observed in session by the school district. Ms. Smith stated she understands that prior to having children from the program present, all hazardous items shall be inaccessible and remain inaccessible during program's hours operation. There are several bathrooms for the children which include toilets and sinks and afford privacy. There is a separate staff restroom. Children will be escorted to/from the bathrooms at all times. The classrooms were not measured as they are exempt from square footage requirements as long as they are certified by the principal for use as classrooms during the day. Food preparation for snacks will be done in Room 604. Isolation for ill children will be the school's office. There is an operational carbon monoxide detector located in Room 707. The playground to be used is the middle school's basketball court, tennis court, football field and one grassy area. There is shade available and drinking fountainsl throughout the middle school campus. Ms. Smith is reminded to keep anything that reads, “Keep Out of Reach of Children” inaccessible to children. See 809-C for continuation...

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha Clenista	TELEPHONE: (619) 818-6740
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022

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: CARLSBAD EDUCATIONAL FOUNDATION - VALLEY MIDDLE	FACILITY NUMBER: 376701190
	VISIT DATE: 06/02/2022

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
26
27
28
29
30
31
32

Facility has an approved Incidental Medical Services (IMS) plan in place. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website. Please go to www.ccld.ca.gov and click on “Receive Important Updates,” then enter your email address and choose which program(s) you would like to subscribe to and click “subscribe.”

A license for 280 children (transitional kinder thru 14-years-old) in 601, 602, 603, 604, 606, 701, 702, 705, 706, 707, Fitness Lab and Multi-Purpose Room (aka gym) is granted and effective today's date, 06/02/2022. In addition, prior to having children in the above classrooms, Ms. Smith will provide LPA with pictures of the rooms appropriately set up with age appropriate furniture and hazardous free. Exit interview was conducted with Ms. Smith. This report shall be kept available at the facility for public review for 3 years. Due to printer malfunction, LPA will email this report, appeal rights, and Notice of Site Visit. Ms. Smith is aware that the NOS form shall be posted for 30 consecutive days.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha Clenista	TELEPHONE: (619) 818-6740
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022

LIC809 (FAS) - (06/04)

Page: 2 of 2