376701514-3-15-2022-20-CC-RGOU-CCJPRR-20220315113309

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701514
Report Date: 03/15/2022
Date Signed: 03/15/2022 11:33:21 AM

Document Has Been Signed on 03/15/2022 11:33 AM - It Cannot Be Edited

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:	EMERSON/BANDINI STATE PRESCHOOL		FACILITY NUMBER:	376701514
ADMINISTRATOR:	JUAN ROMO		FACILITY TYPE:	850
ADDRESS:	1100 SOUTH 36TH STREET		TELEPHONE:	(619) 344-6200
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92113
CAPACITY:	24	CENSUS: 0	DATE:	03/15/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Josephine Condra		TIME COMPLETED:	12:00 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 03/15/22 at 9:00 a.m., Licensing Program Analyst (LPA), Rajani Goudreau arrived at the facility to conduct a pre-licensing (change of location) inspection. Upon arrival LPA, met with Resource Teacher, Josephine Condra and Principle, Juan Romo and proceeded to tour the facility. The facility is requested a capacity of 24 preschool children; serving ages 2 through 5 years old. This preschool program will operate in room E103 in building E at Emerson Elementary. Facility plans to operate under a traditional school calendar with the San Diego Unified School District; Monday through Friday (two sessions) from 8:30 a.m. to 11:30 a.m. and 12:00 p.m. to 3:00 p.m. This facility is a Title-5 program. The total indoor space measures 1,078.70 square feet which is sufficient to accommodate 30 children at one time. However, the facility is requesting a capacity of 24 children. The classroom is currently not set up to care for children. As the equipment is currently being used by the licensed location. There is a restroom in the classroom containing four sinks and four toilets. The children will have exclusive use of the restroom located in the classroom. There is one sink in the classroom near the restroom and three sinks in the outdoor play area available for children's use. The number of toilets and sinks are sufficient to accommodate the requested capacity of 24 children. The restroom and the hand washing areas are in a safe, sanitary and operating condition. Drinking water is readily available during indoor and outdoor activities through the use of water bottle filling stations and water fountains. The school site will provide breakfast and lunch. The nurse’s office and the restroom located in the nurse’s office will be designated for ill children, if needed. There is a functioning carbon monoxide detector and a first aid kit with required supplies in the classroom. Disinfectants, cleaning solutions, and other hazardous substances were not observed in the classroom or the outdoor play area. The facility will be utilizing manual sign in and sign out. Required documents are not posted in the preschool room. See LIC809-Continuation page.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: EMERSON/BANDINI STATE PRESCHOOL	FACILITY NUMBER: 376701514
	VISIT DATE: 03/15/2022

NARRATIVE

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The outdoor preschool play area was inspected and measures a total of 7,865.73 square feet which is sufficient to accommodate 104 children. The preschool program has exclusive use of the outdoor play area. The outdoor play area is fully fenced and includes a outdoor play structure suitable for age groups 2 through 5 years old and two swings suitable for ages 24 to 48 months. In addition, there is sufficient rubber matting material for cushioning underneath the play structure and swings. The outdoor activity space surface is observed to be free of hazards. There are shaded rest areas available during outdoor activities by the use of building shade awnings and shade kites on the play structure. There is are no evidence of rodent or insect activity. Proper supervision and placement of staff during outdoor activities was advised to ensure the supervision and the safety of children.

This facility provides Incidental Medical Services - IMS. IMS plan submitted and approved. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.

LPA reviewed with facility representative, Josephine Condra 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.

The following documents are pending to the department with a due date of March 23, 2022:

Required documents posted
Classroom E103 set up to care for children
Lead Prevention training certificate

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: EMERSON/BANDINI STATE PRESCHOOL	FACILITY NUMBER: 376701514
	VISIT DATE: 03/15/2022

NARRATIVE

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A fire clearance for 24 preschool children in room E103 was granted on January 12,2022.

The following reports were discussed and provided during the inspection: LIC809 reports and Appeal Rights (LIC9058). Once the pending documents are received a license will be issued for 24 Preschool children ages 2 through 5 years old in preschool room E103, after final file review. After final file review the license will be mailed to the facility and upon receipt shall be posed in a prominent location in the facility. Exit interview conducted and report was reviewed with the facility representative, Josephine Condra.

SUPERVISOR'S NAME: Tulam Vu	TELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani Goudreau	TELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

LIC809 (FAS) - (06/04)

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