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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370805130
Report Date: 10/23/2024
Date Signed: 10/23/2024 10:06:35 AM

Document Has Been Signed on 10/23/2024 10:06 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ASSOCIATED STUDENTS CHILD CARE CENTERFACILITY NUMBER:
370805130
ADMINISTRATOR/
DIRECTOR:		MICHELLE ZAMORAFACILITY TYPE:
850
ADDRESS:5500 CAMPANILE DRIVETELEPHONE:
(619) 594-7941
CITY:SAN DIEGOSTATE: CAZIP CODE:
92182
CAPACITY: 136TOTAL ENROLLED CHILDREN: 136CENSUS: DATE:
10/23/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:27 AM
MET WITH:Michelle ZamoraTIME VISIT/
INSPECTION COMPLETED:
10:10 AM
NARRATIVE
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On 10/23/24 @ 8:27AM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced follow-up inspection in reference to a self-reported unusual incident that was reported on 9/17/24. LPA met with Michelle Zamora, Site Director and Sara Sanders, Ass't Director.

LPA interviewed staff today. Present were 101 children.

Type B deficiency is cited today. Type B deficiency if not corrected poses a potential risk to the health, safety or personal rights of clients in care.

Exit interview was conducted with Mrs. Zamora and Mrs. Sanders. Report was reviewed and copy was provided. Notice of site visit and appeal rights were also given. Notice of site visit must be posted for 30 days.

See LIC 809D for citation.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
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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Document Has Been Signed on 10/23/2024 10:06 AM - It Cannot Be Edited


Created By: Nancy Diaz On 10/23/2024 at 09:27 AM
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: ASSOCIATED STUDENTS CHILD CARE CENTER
FACILITY NUMBER: 370805130

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/30/2024
Section Cited
CCR
101223

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PERSONAL RIGHTS
To be free from corporal or unusual punishment, infliction of pain,...

This requirement was not met as evidenced by:
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Mrs. Zamora stated that facility conducted training on Oct. 18th that covered interaction and tone with children, communication with parents, Engaging in curriculum. There is a staff meeting scheduled for November 15th. Smart Horizons handout was provided today for courses recommendations. Mrs. Zamora will submit an agenda and staff attendance no later than end of November 15, 2024.
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Based on information gathered, a staff was observed to have grabbed a child inappropriately.
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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:Joelle Redding
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 10/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2024


LIC809 (FAS) - (06/04)
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