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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370800967
Report Date: 11/13/2024
Date Signed: 11/13/2024 06:15:06 PM

Document Has Been Signed on 11/13/2024 06:15 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CITY TREE CHRISTIAN SCHOOLFACILITY NUMBER:
370800967
ADMINISTRATOR/
DIRECTOR:
LISA PHIPPSFACILITY TYPE:
850
ADDRESS:320 DATE STREETTELEPHONE:
(619) 232-3794
CITY:SAN DIEGOSTATE: CAZIP CODE:
92101
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 38DATE:
11/13/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:Facility Director Lisa PhippsTIME VISIT/
INSPECTION COMPLETED:
06:15 PM
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On 11/13/24 at 3:30PM, Licensing Program Analyst (LPA) Luigi Gargaro, conducted an unannounced annual inspection visit and met with facility director Lisa Phipps. LPA disclosed the purpose of the visit and toured the facility indoors and outdoors. The preschool program consists of a full day program which runs from 6:45AM-6:00PM and operates year round. Days of operation are Monday-Friday.

There are currently five classrooms, out of the seven licensed ones, in operation at the facility. The following ratios were observed: Room 100: There were 9 children present under the supervision of teacher Kelcie Moorehead; Room 101: There were 10 children present under the supervision of teacher Jessica Bogan; Room 104: There were 3 children present under the supervision of teacher Karrie Buckley; Room 105: There were 8 children present under the supervision of teacher Natalii Ledezma; and Room 201: there were 8 children present under the supervision of teacher Marilyn Phan.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible. No poisons were observed during the inspection.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe.

The facility does not serve prepared meals but instead has parents provide any meals and snacks for children to bring with them to the facility. The facility stores and serves all meals and snacks brought in by children. Drinking water is available both indoors and outdoors.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: CITY TREE CHRISTIAN SCHOOL
FACILITY NUMBER: 370800967
VISIT DATE: 11/13/2024
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The outdoor play area is a fenced playground that contains within it a play yard for the school's infant program. The yard has its own separate and secured gating that keeps it distinct from the preschool playground. The preschool children also use a rooftop playground that is shared on an alternating schedule with the elementary school children. The alternating rooftop playground schedule was previously granted waiver approval by CCL. The surface of the outdoor activity space is maintained in a safe condition and free of hazards. Areas around any high climbing equipment, swings and slides have cushioning material to absorb falls. The facility is free of flies, insects and rodents. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements.

A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Upon notification from the Department, the licensee will comply and act immediately to terminate the employment of, remove from the facility or bar from entering the facility for any person it is deemed necessary while the Department considers granting or denying an exemption. Capacity and limitations as specified on the license are being maintained. At least one opening and closing staff member has current CPR/First Aid certifications.

The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. All children are under supervision, including visual supervision, of a teacher at all times. LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child. The analyst reviewed staff files which contained health screening and current documentation of completed mandated reporter training. Not all staff for whom records were reviewed had copies of proof required immunizations in their files.

This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. The facility has a documented IMS plan in place. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
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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: CITY TREE CHRISTIAN SCHOOL
FACILITY NUMBER: 370800967
VISIT DATE: 11/13/2024
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LPA provided the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, California Megan’s Law (www.meganslaw.ca.gov), Lead Poisoning Facts, Forms and Regulations.

One type B violation was cited during today's visit. An exit interview was conducted with Director Phipps and she was provided with a copy of today's report and the facility's appeal rights (LIC 9058). This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/13/2024 06:15 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 11/13/2024 at 05:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CITY TREE CHRISTIAN SCHOOL

FACILITY NUMBER: 370800967

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 11/13/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(2)
Health-Related Services
(2) All prescription and nonprescription medications shall be maintained with the child's name and shall be dated.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on analyst observation, the licensee did not comply with the section cited above as an epi pen kept for child #1 expired as of January of 2024 which poses/posed a potential health, safety or personal rights risk to a child in care.
POC Due Date: 11/22/2024
Plan of Correction
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Director states she will contact parent and have her provide a new epi pen and then send analyst a copy of pen clearly showing it is dated for the child by 11/22/24 to complete the correction.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Jason Garay
LICENSING EVALUATOR NAME:Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE: 11/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/13/2024


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