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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005101
Report Date: 09/16/2021
Date Signed: 09/21/2021 01:59:42 PM

Document Has Been Signed on 09/21/2021 01:59 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:CARMEL MOUNTAIN PRESCHOOLFACILITY NUMBER:
372005101
ADMINISTRATOR:DONNA TACONIFACILITY TYPE:
850
ADDRESS:9510 CARMEL MOUNTAIN ROADTELEPHONE:
(858) 484-4877
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY: 249TOTAL ENROLLED CHILDREN: 249CENSUS: DATE:
09/16/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Arianne Bettazzi/Executive DirectorTIME COMPLETED:
12:30 PM
NARRATIVE
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This is an amended report originally signed on 09/16/2021.
On 9/16/2021 at 10:15am, Licensing Program Analysts (LPAs) Selina Siao and Samantha Clenista conducted an unannounced Plan of Correction visit for the citation issued on 09/01/2021. LPAs met with Executive Director, Arianne Bettazzi and conducted a tour of the classrooms.

All staff members that are present today have the required background clearances and are associated to the facility. All staff members are wearing appropriate face coverings. 19 out of 80 children that are inside the classrooms were observed not wearing any face covering or mask. Facility is not following the mask mandate requirement that indicates that children over 2 year are to wear face covering/masks indoor per County of San Diego and California Department of Public Health. Facility's website indicates that their COVID-19 Health and Safety Protocols states that all adults must wear a mask while inside facility.

See LIC809D for Type A citation issued and civil penalty of $800 for failure to correct is being assessed today.

“Licensee shall provide copies of this document to parents/guardians of children in care and to parents/guardians of children newly enrolled at the facility during the next 12 months.”

Appeal Rights (1/16) were discussed and provided. Signature at the bottom of this report confirms receipt. Notice of Site Visit was posted and will remain posted for 30 days. Failure to keep the posting will result in $100 civil penalty.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2021
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 09/21/2021 02:00 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 09/21/2021 10:40 AM


Created By: Selina Siao On 09/16/2021 at 08:36 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CARMEL MOUNTAIN PRESCHOOL
FACILITY NUMBER: 372005101

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/16/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/22/2021
Section Cited
CCR
101223(a)(2)

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Personal Rights-The licensee shall ensure that each child is accorded the folloiwng personal rights.. To be accorded safe, healthful.. accomodations.. to meet his/her needs. This requirement is not met as evidence by
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Facility representation will submit a written statement indicating how they will ensure children are wearing masks indoors to Analyst by 9/22/21.
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Based on LPA's observation on 09/01/2021, today, interviews conducted and facility's health and safety protocols. Facility is not following the mask mandates, children over 2 are to wear face covering/mask indoor. 19 out of 80 indoor children are wearing a face covering today. Civil penalty of $800 is being assessed for failure to correct the citation issued on 09/01/2021. This poses an immediate health and safety risk to clients in care.
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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:Monica Cuddy
LICENSING EVALUATOR NAME:Selina Siao
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2021


LIC809 (FAS) - (06/04)
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