370800551-11-1-2023-20-CC-VWIN-CX6VB9-20231101161712

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 370800551
Report Date: 11/01/2023
Date Signed: 11/01/2023 04:17:15 PM

Document Has Been Signed on 11/01/2023 04:17 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	ST ANDREWS EPISCOPAL PARISH DAY SCHOOL		FACILITY NUMBER:	370800551
ADMINISTRATOR:	JULIANN SCOLARI		FACILITY TYPE:	850
ADDRESS:	4816 GLEN STREET		TELEPHONE:	(619) 469-5330
CITY:	LA MESA	STATE: CA	ZIP CODE:	91941
CAPACITY: 90	TOTAL ENROLLED CHILDREN: 76	CENSUS: 51	DATE:	11/01/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Juliann Scolari		TIME COMPLETED:	04:30 PM

NARRATIVE

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On 11/1/2023, at 2:15pm, Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management inspection regarding a self - reported incident. LPA met with Director, Juliann Scolari. LPA discussed the purpose of the inspection and was led on a tour of the facility. The following ratios were observed: Room 1 had eight children present with one staff, Room 2 had eight children present with two staff, Room 3 had seven children present with one staff, Room 4 had nine children (ages 18 - 36 months) present with two staff, Room 5 had eight children present with one staff, Room 7 had eight children present with two staff.

On 10/27/2023, the director self- reported an incident involving Child #1 (C1) [See Confidential Names]. Per Director, the incident occurred on 10/27/2023 at around 11:00am.

Director reported that Child #1 (C1)was playing on the playground on a play structure when he sustained an injury. Interviews were conducted with the Director, Staff #1 (S1) [See Confidential Names] and C1's authorized representative. S1 stated that C1 was climbing up the ladder of the play structure when he missed a step and fell onto the cushioning area around the play structure. C1 sustained an injury and was immediately taken to the office. Director stated that an ice pack was applied to the injury and C1's authorized representative was contacted immediately. S1 stated that she was supervising eight children on the playground during the time of the incident and was near C1 however was unable to break the fall.

LPA's observation of the play structure confirmed that it is age appropriate. Based on interviews and LPA's observation, the incident was determined to be an accident.

No deficiencies cited. An exit interview was conducted with Director, Juliann Scolari, and a copy of this report, Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit is required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. LPA observed Notice of Site Visit posted on the bulletin board in by the parent kiosk..

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023

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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