376701328-12-6-2019-20-CC-RGOU-BJLVAW-20191206151638

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701328
Report Date: 12/06/2019
Date Signed: 12/06/2019 03:16:46 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:	RISING STAR PRESCHOOL		FACILITY NUMBER:	376701328
ADMINISTRATOR:	TERRI BERCASIO		FACILITY TYPE:	830
ADDRESS:	3054 FAIRMONT AVENUE		TELEPHONE:	(619) 213-9356
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY:	18	CENSUS: 4	DATE:	12/06/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:48 PM
MET WITH:	Terri Bercasico		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 (LPA), Rajani Goudreau, made an unannounced visit for the purpose of a random annual inspection. Upon arrival, LPA met with Director, Terri Bercasio and proceeded to tour the facility. There were four infants in care with one staff member. Facility is within ratio and capacity limitations. Program operates: Monday through Friday from 6:30pm to 5:30pm. The furniture and toys, both inside and out, are safe, age-appropriate and in good repair. Infant classroom has adequate heating, lighting and ventilation, are clean and orderly, and are free of hazards. Infant changing table is padded with washable vinyl at least one inch thick with sides raised at least 3 inches, per regulation. All storage containers and trashes have tight fitting covers and are in good repair. All foods/beverages are labeled/dated and stored, per regulation in the infant room refrigerator. Facility provides am and pm snack to children. Lunch is brought from home. Feeding high chairs for infants are in good repair and made of a washable, moisture resistant material. The last fire and earthquake drill was conducted on 11/14/19. All hazardous items are stored where they are inaccessible to children. The outdoor play area is fenced with no climbing structures and has adequate shade and is separate from the preschool playground. There are no bodies of water, firearms or ammunition on the property. There is no evidence of rodent or insect activity. The carbon monoxide detector is operational, per LPA observation. There is at least one staff present with a current CPR and First Aid certification. Sign in/out sheets were current and complete. Infant Needs and Services Plans were on file for all infants. Personnel records were reviewed for educational qualifications. A sample of children’s records were reviewed for emergency information and a medical assessment. SB 792 (staff immunizations) and AB 1207 (Mandated Reporter Training) requirements have been met. See LIC809-C continuation page...

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2019

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

LIC809 (FAS) - (06/04)

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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: RISING STAR PRESCHOOL	FACILITY NUMBER: 376701328
	VISIT DATE: 12/06/2019

NARRATIVE

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Facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com. SIDS was discussed (Child Care Providers Guide to Safe Sleep Handout provided). Isolation area is the Director's office. LPA informed Director to ensure status with California Secretary of State for Non-Profit remains in active status. Current status for Non-Profit is inactive. Director indicated she will contact the Secretary of State regarding inactive status.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When any IMS is provided, an updated 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. Services are in place.

Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

LPAs informed Director to provide the following to Licensing no later than 12/31/19

Provide an updated LIC200A- Application for a child care Center License – Original, reflecting correct licensee’s name matching with the California Secretary of State.

No deficiencies cited during today’s visit. LPA conducted an exit interview with Director. LPA provided Director with the following; LIC809-LIC809D, appeal rights and LIC9213-Notice of Site Visit. LPA informed Director, LIC9213 must be posted for 30 days from today’s date. LPA observed Director post notice of site visit prior to exiting facility.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2019

LIC809 (FAS) - (06/04)

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