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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370806001
Report Date: 02/06/2025
Date Signed: 02/06/2025 03:43:01 PM

Document Has Been Signed on 02/06/2025 03:43 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:KIDS CORNER INC.FACILITY NUMBER:
370806001
ADMINISTRATOR/
DIRECTOR:		MICHAEL GOLOVKOFACILITY TYPE:
840
ADDRESS:1425 WASHINGTON PLACETELEPHONE:
(619) 295-8344
CITY:SAN DIEGOSTATE: CAZIP CODE:
92103
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 56DATE:
02/06/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Zachary GolovkoTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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On 2/6/25, at 2:00 pm, Licensing Program Analyst (LPA), Victoria Hernandez conducted an unannounced annual required inspection. LPA met with Licensee Representative, Zackary Golovko and toured the facility. Upon LPA's arrival there were twenty-four (24) children present, throughout the inspection additional children arrived. The Licensee Representative and four (4) staff were supervising 56 children during today's inspection.

Furniture and equipment are in good condition. Playground equipment is in safe condition. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. Toilets and hand-washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. Food preparation and storage areas are clean. Food is protected against contamination and any contaminated food is discarded immediately. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. Facility has a functioning carbon monoxide detector that met statutory requirements. Snack Menus are posted monthly.

Program Director stated there are no swimming pools or other bodies of water on the premises. Program Director stated there are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible to children.

A review of staff records on this date indicates facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Program Director was reminded that all adults 18 and over, 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.

(CONT 809C...)

SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Victoria Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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 02/06/2025 03:43 PM - It Cannot Be Edited


Created By: Victoria Hernandez On 02/06/2025 at 03:19 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: KIDS CORNER INC.
FACILITY NUMBER: 370806001

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in not conducting an emergency drill every six months which poses a potential health, safety or personal rights risk to persons in care. Last one on file 1/2023
POC Due Date: 02/13/2025
Plan of Correction
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Provider will conduct an emergency drill and send proof to LPA via email
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:Victoria Hernandez
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2025


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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: KIDS CORNER INC.
FACILITY NUMBER: 370806001
VISIT DATE: 02/06/2025
NARRATIVE
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At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at off-site activities. The name of the child care center facility representative or fully- qualified teacher designated to act in the facility representative’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. The licensee has not conducted fire and disaster drills. Required documents are posted.

Children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 14 children in care. 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 and medical assessment.

This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Program Director is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. 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 www.ada.gov/childqanda.htm.

Per California Code of Regulations, (Title 22, division 12 & Chapter 3) , one (1) Type B is being cited on the attached LIC 809-D.



Exit interview conducted with Licensee Representative, Zackary Golovko

Notice of Site Visit was given and is required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Victoria Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
LIC809 (FAS) - (06/04)
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