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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701457
Report Date: 11/12/2020
Date Signed: 11/12/2020 11:23:24 AM

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:GRACE KIDS PRESCHOOL NORTH PARK 2FACILITY NUMBER:
376701457
ADMINISTRATOR:LATERESA OROPEZAFACILITY TYPE:
850
ADDRESS:2930 HOWARD AVENUETELEPHONE:
(619) 741-3555
CITY:SAN DIEGOSTATE: CAZIP CODE:
92104
CAPACITY:61CENSUS: 24DATE:
11/12/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Lateresa OropezaTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a case management inspection to follow-up on an incident that occurred on 10/29/2020. Due to the Covid 19 outbreak, this inspection was done as a tele visit on the FaceTime platform with Director Lateresa Oropeza.

The following ratios were observed in 4 classrooms: Room 1 and Room 2 were empty. Room 4 had eight (8) children supervised by one (1) staff member. Room 3 AKA 5 had eight (8) children supervised by one (1) staff member. Remaining children were in the bathroom. LPA observed the children to be involved in indoor activities and preparing for outdoor activities. Appropriate ratios were maintained, and visual observation noted.

A child sustained an injury and required medical treatment on 10/29/20209. The incident was self reported by the facility and a written report was received in the Licensing office within the required reporting period. There were eight (8) children in the bathroom with two (2) staff during the incident. On 10/29/2020, at about 2:40 PM, the child was in their bathroom washing their hands; due to the child’s size, they stood on an age appropriate stool while washing their hands. While the child washed their hands, they slipped on the stool causing the child to fall hitting the back of their head under the pedestal sink. Staff immediately attended to the child by applying pressure and ice to the area. Staff also immediately contacted the parent. The bathroom was observed to be age appropriate. No apparent hazards accessible to children were observed. The incident appears accidental, the facility took prompt action by administering first aid and notifying the parent. No deficiencies cited.

Staff was electronically provided with A Notice of Site Visit (LIC 9213), which is to be posted for thirty (30) days. An exit interview was conducted. A copy of this report and Licensee/Appeal Rights (LIC 9058) will be e-mailed to the director. The director was advised that acknowledgement of the receipt of the report is to be received within twenty-four hours.




SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2020
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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