376701220-7-10-2023-51-CC-RASW-CTPQMJ-20230713121736

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376701220
Report Date: 07/10/2023
Date Signed: 07/10/2023 01:50:46 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/03/2023 and conducted by Evaluator Adrian L Mangina

COMPLAINT CONTROL NUMBER: 51-CC-20230403131129

FACILITY NAME:	PLAYHOUSE PRESCHOOL FOREVER YOUNG		FACILITY NUMBER:	376701220
ADMINISTRATOR:	SHERRIE FOSTER		FACILITY TYPE:	850
ADDRESS:	7045 FORUM STREET		TELEPHONE:	(858) 279-2016
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92111
CAPACITY:	78	CENSUS:	DATE:	07/10/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Sherrie Foster		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Day care child sustained injuries including a fracture due to lack of staff supervision

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 7/12/23 at 1:30 PMLicensing Program Analyst (LPA) Adrian Mangina made an unannounced inspection for the purpose of delivering findings for the complaint received on 4/3/23, regarding the above allegation. LPA met with Director, Sherrie Foster. Also present in the facility were 2 teachers, 2 aids and Director in 2 classrooms with 23 napping daycare children present. Proper ratios and supervision were observed.

Based on the information obtained during interviews, observations, and documentation reviewed it is determined that facility staff failed to provide adequate supervision to prevent child 1 from climbing on unsecured shelving which resulted in a fall and subsequent injury. There were two staff with 20 children present, but one was engaged with a parent during the incident, leaving only one to supervise. Investigation revealedd that similar shelves were used throughout the facility which were secured for safety. Because unsecured shelving is a known hazard, staff should have provided a higher level of supervision to children playing near the shelf to prevent injury.
(continued on LIC9099 page 2)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 51-CC-20230403131129

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: PLAYHOUSE PRESCHOOL FOREVER YOUNG	FACILITY NUMBER: 376701220
	VISIT DATE: 07/10/2023

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

(LIC9099 page 2)

The allegation is valid because the preponderance of the evidence has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations,, (Title 22, Division 12, Chapter number 1). See LIC9099-D for Type A citation.

LPA Mangina informed facility representative that this report dated 7/12/23 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Mangina informed facility representative to provide a copy of this licensing report dated 7/12/23 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISOR'S NAME: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 51-CC-20230403131129

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: PLAYHOUSE PRESCHOOL FOREVER YOUNG	FACILITY NUMBER: 376701220
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/10/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/11/2023 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION: the licensee shall provide care and supervision as necessary to meet the children's needs. This requirements was not met as evidenced by:	1 2 3 4 5 6 7	Shelf has been placed in Director's office making it inaccessible. Facility Representative states will provide a written plan of correction to include how they will ensure proper supervision and ratios in the future and training shall be provided within 30
	8 9 10 11 12 13 14	Based on the information obtained during interviews, observations, & records reviewed it is determined that Staff failed to provide adequate supervision to prevent child 1 from being seriously injured in fall from unsecured shelf, which posed an immediate health, safety or personal rights risk to children in care.	8 9 10 11 12 13 14	days and copy of sign in sheet and training materials will be provided to the Department on or before 8/10/23.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	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: Renesha Askew	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Adrian L Mangina	TELEPHONE: (619) 629-6197
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3