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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701402
Report Date: 12/01/2020
Date Signed: 12/01/2020 04:05:52 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:HILLTOP PRESCHOOLFACILITY NUMBER:
376701402
ADMINISTRATOR:MARLA MARTINFACILITY TYPE:
850
ADDRESS:12348B CASA AVENIDATELEPHONE:
(858) 486-6712
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY:125CENSUS: 32DATE:
12/01/2020
TYPE OF VISIT:Case Management - IncidentANNOUNCEDTIME BEGAN:
02:30 AM
MET WITH:Marla MartinTIME COMPLETED:
03:15 AM
NARRATIVE
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This is a continuation of a case management visit that began earlier today. On 12/1/2020 at 8:15 AM, Licensing Program Analysts (LPAs) Keturah Lane and Patrick Ma conducted an unannounced case management tele-inspection via Zoom due to COVID-19 State of Emergency and met with Director Marla Martin. The purpose of the visit was to inquire about recent positive cases of COVID-19 at the facility and compliance with COVID-19 guidelines. Due to staffing shortages caused by COVID-19 positive cases, the Director had to end the earlier meeting to attend to the children. The meeting was concluded at 9:07 AM. LPA Lane and Director Martin arranged to continue the tele-visit at 2:30 PM today (12/1/2020) via FaceTime. LPA Ma was unable to attend the continuation meeting.

Director Marla Martin gave a tour of the open classrooms at the facility. During the tour, LPA Lane observed appropriate care and visual supervision, appropriate ratios and capacities. Facility appears to be following COVID-19 guidelines and no immediate hazards were observed by LPA.

Reporting requirements and Covid-19 guidance were reviewed with Director Martin. Licensee was provided with copies via e-mail of: Covid-19 Guidance (7/17/20), CAL-OSHA guidance, Childcare Decision Tree, COVID-19 Self-Assessment, posters to display, list of websites for more information and a link to a mask video for children. After reviewing staff records, it was determined that Staff #1, who also tested positive for COVID-19, did not have a fingerprint clearance prior to volunteering at the facility.

Today, deficiency cited under Title 22 Division 12 Appeal rights given.

(Continued on LIC809-C...)
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2020
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 3
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: HILLTOP PRESCHOOL
FACILITY NUMBER: 376701402
VISIT DATE: 12/01/2020
NARRATIVE
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Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide Acknowledgement of Receipt of Licensing Reports (LIC 9224) for each child in care and have each parent sign the form that they have received a copy of the report LIC 809, LIC809-C and LIC 809D.
THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.

CIVIL PENALTIES were assessed in the amount of $500. Licensee was provided a copy of Civil Penalties Assessment LIC421BG.

An exit interview was conducted with applicant. A Notice of Site Visit (LIC9213) and Appeal Rights (LIC9058) will be sent along with the reports (LIC809, LIC809-C, LIC809D, LIC421BG) via e-mail to the Licensee. Licensee will confirm receipt of these reports via e-mail and the reply of confirmation will serve as the signature acknowledging these rights. The Notice of Site Visit (LIC9213) must remain posted for 30 days.

SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: HILLTOP PRESCHOOL
FACILITY NUMBER: 376701402
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/02/2020
Section Cited

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101216(i)(1)-Personnel Requirements (i) Prior to employment or initial presence in the child care center, all employees and volunteers subject to criminal record review shall (1) obtain a California clearance...as required by law or Department regulations. This requirement was not met as evidenced by...
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Based upon LPA's review of staff records, Staff Member #1 did not have a fingerprint clearance.
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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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2020
LIC809 (FAS) - (06/04)
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