376701513-2-4-2022-20-CC-MMAE-CBBTEE-20220204133949

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701513
Report Date: 02/04/2022
Date Signed: 02/04/2022 01:39:53 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:	CAMP ASPEN LEAF		FACILITY NUMBER:	376701513
ADMINISTRATOR:	AMANDA MASIELLO		FACILITY TYPE:	840
ADDRESS:	1730 MONROE AVENUE, SUITE C		TELEPHONE:	(619) 405-1694
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92116
CAPACITY:	24	CENSUS: 0	DATE:	02/04/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Bridget Wu		TIME COMPLETED:	02:00 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	On 2/4/22 at 12:30pm, Licensing Program Analyst (LPA), Martha Malane arrived at the facility to conduct a pre-licensing inspection. Upon arrival, LPA met with facility representative Bridget Wu and Director, Amanda Masiello and proceeded to tour the facility. The facility is requesting a capacity of 24 school-age children (age 5 years – 11 years) in the After-School Room. Facility plans to operate Monday through Friday from 7:00am to 6:00pm. The After-School Room was inspected and measured a total of 1163.47 square feet which is sufficient to accommodate 33 children. The classroom is equipped with appropriate furniture; including tables, chairs, cubbies, bookshelves, and other materials for children’s use. LPA observed the furniture and equipment to be in good condition. There is a functioning carbon monoxide detector and a first aid kit with required supplies. Disinfectants, cleaning solutions are kept inaccessible in the utility closet. Drinking water is available indoors and outdoors refillable water bottles brought from home. The facility utilizes manual sign in and sign out sheets. There are two (2) restrooms, each restroom containing one sink and one toilet for the children's use, offering individual privacy which is sufficient to accommodate the requested capacity. The restrooms were observed to be in safe and sanitary operating condition. There is a restroom for isolation for ill children if needed and the 'Comfort Corner' will be utilized for isolation if needed. LPA observed the floors in the facility to be clean and safe. There is only one outdoor activity space available, which the applicant plans to utilize for infants, toddlers and school age. The outdoor activity space measured a total of 785.05 square feet which is sufficient to accommodate 10 children, however applicant is requesting a capacity of 24 school age children and a license for 12 infants and 12 toddlers. Applicant will submit a waiver plan for outdoor use for the requested capacity of 12 infants, 12 toddlers and 24 school age children to be reviewed by the Department. Shade is provided through the use of a canopy and shade sail. LPA observed toys and materials available for outdoor play. Proper supervision and placement of staff outside was discussed to ensure the safety of children at all times. See LIC809C continuation page...

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha Malane	TELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022

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: CAMP ASPEN LEAF	FACILITY NUMBER: 376701513
	VISIT DATE: 02/04/2022

NARRATIVE

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Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA reviewed with facility representative the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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.

A fire clearance was granted on 12/23/2021 for 24 children in the after-school room.

The following is needed prior to licensure:
1. Applicant will submit a waiver plan request to the Department for the outdoor activity space

An exit interview was conducted with facility representative Bridget Wu and Director, Amanda Masiello.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha Malane	TELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022

LIC809 (FAS) - (06/04)

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