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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701413
Report Date: 06/26/2019
Date Signed: 06/26/2019 03:05:09 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:LITTLE ANGELS ACADEMYFACILITY NUMBER:
376701413
ADMINISTRATOR:ANAHIT ANTONYANFACILITY TYPE:
830
ADDRESS:3078 L STREETTELEPHONE:
(619) 458-9553
CITY:SAN DIEGOSTATE: CAZIP CODE:
92102
CAPACITY:32CENSUS: 20DATE:
06/26/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:26 PM
MET WITH:Hunan ArshakianTIME COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Selina Siao and Elizabeth Rivera conducted a case management inspection. Upon arrival, LPAs met with Administrator Huana Arshakian and conducted a tour of the facility. The following ratios were observed: Room 2 had 6 infants (3 awake and 3 napping in the crib area) supervised by teacher Melissa Wright and teacher aide Mayte Ortega Fiesco. Room 5 (older walking infants class) had 10 infants napping on cots and were supervised by teacher Yaritza Mendoza. Room 6 had 4 awake infants supervised by teacher Paola Ayon Castro and staff Elizabeth Hernandez De La Rosa.

Staff Elizabeth Hernandez De La Rosa has been working at the facility since this week and has the required background clearances but she is not associated to this facility. Civil penalty of $100 will be issue today. See LIC809D for type A citation issue today.

“Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. “
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
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: LITTLE ANGELS ACADEMY
FACILITY NUMBER: 376701413
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/27/2019
Section Cited
CCR
101170(e)(2)
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All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified in Section 101170(f).
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Administrator stated that he will be sure to keep the criminal background clearances transfer request transmittal at the facility. Administrator faxed the background transfer request to Licensing during
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This requirement is not met as staff Elizabeth Hernandez De La Rosa has the required background clearances but she is not associated to the facility. This poses an immediate health and safety risk to clients in care.

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today's inspection. A fax confirmation was obtained.
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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: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
LIC809 (FAS) - (06/04)
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