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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005101
Report Date: 08/22/2025
Date Signed: 08/22/2025 02:21:06 PM

Document Has Been Signed on 08/22/2025 02:21 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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CARMEL MOUNTAIN PRESCHOOLFACILITY NUMBER:
372005101
ADMINISTRATOR/
DIRECTOR:		DONNA TACONIFACILITY TYPE:
850
ADDRESS:9510 CARMEL MOUNTAIN ROADTELEPHONE:
(858) 484-4877
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY: 249TOTAL ENROLLED CHILDREN: 249CENSUS: 135DATE:
08/22/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:10 AM
MET WITH:Karina Montoya BarrettTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
NARRATIVE
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On 8/22/2025 @ 8:10AM, Licensing Program Analysts (LPAs) Nancy Diaz and Mahjoba Mohsini conducted an unannounced inspection. A tour of the facility was conducted with Carol Fugleberg (Resource Manager) and Karina Montoya Barrett. Observed present today were 135 children in the following classrooms:
  • Room 1A with 4 children and staff Amanda Templin
  • Room 1B with 6 children and staff Satya Sana & Haley McCann
  • Room 2A & 3A with 8 children and staff Autumn Gates; Merrick Rosales; Beth Hicks & Ruby Keene
  • Rooms 2B with 5 children and staff Chantelle Mahusay; Nicole O'Neal & Carolina Mittelstaedt
  • Room 3B with 6 children and staff Jocelyn Kha & CAillie Cree
  • Room 4B with 4 children and staff Kiana Dela Rosa & Juliana Arguelles
  • Room 5A with 7 children and staff Amanda Hanna; Veronica Ninteman & Jovel Loprete
  • Room 5B with 11 children and staff Sydney Aguilar and Leah DelaCruz
  • Room 6A with 3 children and staff Marisol Vidauri
  • Room 6B with 4 children and staff Yui Karino & Cassandra Hutter
  • Room 6C with 4 children and staff Emma Bromhead and Natalie Lazor
  • Room 7 with 10 children and staff Jacklyn Romero
  • Room 8 with 7 children and staff Lisa Hall
  • Room 9 with 6 children and staff Corinne Bunce
  • Room 10 with 8 children and staff Madeline Beck
  • Room 11 with 10 children and staff Melissa Hamand
  • Room 12A with 9 children and staff Michelle Butler Sheffler
  • Room 12 B with 5 children and staff Ruthi Enriquez; Grecia Mejia Guzman and Margaret Reyes
Continued on LIC809C and LIC809D.
NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Nancy Diaz
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 08/22/2025 02:21 PM - It Cannot Be Edited


Created By: Nancy Diaz On 08/22/2025 at 11:04 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: CARMEL MOUNTAIN PRESCHOOL
FACILITY NUMBER: 372005101

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
08/22/2025
Section Cited
CCR
101170(e)(1)

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CRIMINAL RECORD CLEARANCE.
All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:
(1) Obtain a California clearance...
This requirement was not met as evidenced by:
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S2 left at noon today to obtain Livescan fingerprint clearance. Mrs. Barrett was reminded that S2 may not return to work until a fingerprint clearance is received.
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Based on record review (Guardian Database), staff S2's fingerprint clearance is not on Guardian Database. S2 was employed on 1/19/2023.
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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.
Joelle Redding
NAME OF LICENSING PROGRAM MANAGER:
Nancy Diaz
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2025


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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CARMEL MOUNTAIN PRESCHOOL
FACILITY NUMBER: 372005101
VISIT DATE: 08/22/2025
NARRATIVE
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Type A and B deficiencies were cited today. Civil penalties were also assessed.

Type A deficiency if not corrected poses an immediate risk to the health, safety or personal rights of clients in care.

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

LPA Nancy Diaz informed Ass't Director Karina Barrett that this report dated August 22, 2025 document 1Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
Also, LPA Nancy Diaz informed the Ass't Director Karina Barrett to provide a copy of this licensing report dated August 22, 2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Please be advised that FAILURE TO PAY the required civil penalty payment may result in in the REVOCATION OF YOUR LICENSE. You must respond within 30 days with the payment of or a proposed payment plan that includes the first payment. Further, the Department will not approve any requests for increase in capacity or for additional capacity of additional licenses while civil penalties remain unpaid.

Exit interview was conducted with Karina Barrett. LPA reviewed and provided a copy of this report. Appeal rights and notice of site visit were also given.
NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Nancy Diaz
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 08/22/2025 02:21 PM - It Cannot Be Edited


Created By: Nancy Diaz On 08/22/2025 at 01:18 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: CARMEL MOUNTAIN PRESCHOOL
FACILITY NUMBER: 372005101

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
08/22/2025
Section Cited
CCR
101170(e)(2)

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CRIMINAL RECORD CLEARANCE.
All individuals subject to a criminal record review pursuant to H & S Code Section 1596.871 shall prior to working...Request a transfer of a criminal record clearance...

This requirement was not met as evidenced by:
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CORRECTED TODAY.
Ass't Director associated S1; S3 and S4's fingerprint clearance were associated to the facility today, 8/22/2025. Copies of fingerprint association were provided to LPA today.
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Based on record review (Guardian Database), staff S1; S3 and S4's fingerprint clearances were not associated to the facility.
S1 was employed on 8/11/2023.
S3 was employed on 5/27/2025
S4 was employed on 4/15/2024.
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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.
Joelle Redding
NAME OF LICENSING PROGRAM MANAGER:
Nancy Diaz
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2025


LIC809 (FAS) - (06/04)
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