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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005598
Report Date: 04/08/2025
Date Signed: 04/08/2025 04:42:42 PM

Document Has Been Signed on 04/08/2025 04:42 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:MAGDALENA ECKE YMCAFACILITY NUMBER:
372005598
ADMINISTRATOR/
DIRECTOR:		KARISA RIDDLEFACILITY TYPE:
850
ADDRESS:200 SAXONY ROADTELEPHONE:
(760) 942-9622
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: 152TOTAL ENROLLED CHILDREN: 152CENSUS: DATE:
04/08/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:10 PM
MET WITH:Janice Lewis and Vicki TallcottTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
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On 4/8/2025 at 3:10PM, Licensing Program Analyst (LPA) Hanna Lucas and Licensing Program Manager (LPM) Joelle Redding, made an unannounced case management visit to follow up a self-reported incident that occurred on 4/3/25 wherein a child (C1), was left behind in the classroom during a transition to the playground. LPA and LPM met the coordinators, Janice Lewis, and Vicki Tallcott, as the Associate Executive Director, Krista Russell arrived later.

LPA and LPM obtained documents pertaining to the incident, including the live roster sheet, which is used to keep track of the children in each classroom, and the employee handbook that states transition procedures, that requires staff to do name to face.

At the time of the incident, the head teacher, (S2) was leaving the classroom to do her scheduled prep work from 3:00PM-3:55PM, and the floater (S1), took over the classroom. S1 transitioned the five children onto the playground between 3:35 to 3:40 p.m. from the double doors at the rear of the classroom, leaving C1 behind, unsupervised. S2 returned back to the classroom at the end of prep time between 3:55 and 4 p.m. and found C1 sitting on the classroom rug. S2 escorted the child onto the playground and the parent was notified. The child was in a secure classroom. Exit doors lead either to the secured playground or into the main portion of the facility where doors are alarmed and staff are at the front desk. The facility responded immediately, taking corrective action. Based on the information, this incident represents a potential health and safety risk to children in care and a Type B deficiency will be cited on the accompanying LIC 809D. Report was read and reviewed with the Executive Director, Karista Russell.

Notice of Site Visit was provided, posted and will remain posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Hanna Lucas
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/08/2025
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 04/08/2025 04:42 PM - It Cannot Be Edited


Created By: Hanna Lucas On 04/08/2025 at 04:18 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: MAGDALENA ECKE YMCA
FACILITY NUMBER: 372005598

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/18/2025
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision...The licensee shall provide care and supervision as necessary to meet the children's needs. No child...shall be left without the supervision of a teacher...Supervision shall include visual observation. This requirement is not met as evidenced by:
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Associate Executive Director Krista Russell stated that immediate action was taken and S1 is no longer employed at the facility. On Thursday, 4/5, all staff were directly reminded of the transition processes and appropriate supervision with an email to follow.
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Based on interviews, observation and review of relevant documentation, on 4/3, Child (C1) was left unsupervised in a classroom for approximately 20-25 minutes during a transition to the playground. This is a potential risk to the health and safety of children in care.
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A formal staff meeting will be held on 4/17. A copy of the agenda and roster will be provided to Licensing via email.

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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:
Hanna Lucas
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/08/2025


LIC809 (FAS) - (06/04)
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