<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005156
Report Date: 03/18/2024
Date Signed: 03/18/2024 09:47:41 AM

Document Has Been Signed on 03/18/2024 09:47 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:MIRAMAR COLLEGE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
372005156
ADMINISTRATOR:WAI-LING RUBICFACILITY TYPE:
850
ADDRESS:10440 BLACK MOUNTAIN ROADTELEPHONE:
(619) 388-7851
CITY:SAN DIEGOSTATE: CAZIP CODE:
92126
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 0DATE:
03/18/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Wai-Ling RubicTIME COMPLETED:
10:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 3/18/2024 @ 9:15 AM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced case management inspection. This is in reference to a self-reported incident involving a 3-year old child who sustained a fractured left elbow when he fell from the play structure. This incident occurred on March 8, 2024. LPA met with Wai-Ling Rubic, Site Director. There were no children observed present today.

Mrs. Rubic also reported that the facility had flooding over the weekend. LPA observed staff moving furnitures and supplies around. Mrs. Rubic anticipates that children will be out for about a week. She also reported that the facility have Spring break on March 25th.

The outdoor play area was observed to be sufficiently cushioned with material that absorbs falls. Mrs. Rubic stated that this incident was witnessed by two staff who were standing approximately 10 ft. away from the play structure. Appropriate first aid was applied immediately to the child. Child was taken to the hospital by the parent who came after receiving a phone call from staff. Child is in a cast for a few weeks and is staying home with the parent until the cast is removed.

No deficiency cited today.

Exit interview was conducted with the Site Director. Report was reviewed and a copy was provided today. Notice of site visit was also given. The notice shall be posted for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1