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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372006511
Report Date: 03/21/2025
Date Signed: 03/21/2025 10:29:43 AM

Document Has Been Signed on 03/21/2025 10:29 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:MAXWELL H. & MURIEL GLUCK CCC, LLC, THEFACILITY NUMBER:
372006511
ADMINISTRATOR/
DIRECTOR:		KRISTY FORDFACILITY TYPE:
850
ADDRESS:10660 JOHN J HOPKINS DRIVETELEPHONE:
(858) 455-5220
CITY:SAN DIEGOSTATE: CAZIP CODE:
92121
CAPACITY: 78TOTAL ENROLLED CHILDREN: 78CENSUS: 63DATE:
03/21/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Kristy Ford TIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 3/21/25 at 8:30AM, LPA Annette Sutherland made an unannounced case management visit for the purpose of following up on 2 self reported incidents that occurred on 3/19/25 when a child (C1) fell and hit their head and & another incident on 3/20/25 where a child tripped and fell and hit their head. Both children received medical attention. Present today were a total of 63 children and 8 staff members.

LPA toured the facility and interviewed Site Director, Kristy Ford. Areas observed were the playground where the incident occurred. Wooden stumps have been at the facility since 2013. At the time of the incident the program was within staff to child ratio requirements. There were 4 staff members present (S1, 2-4) The playground has sufficient padding and is age appropriate. The wood stumps have been removed from the playground temporarily to be resealed and edges rounded. Since the incident a plan has been put in place, to prevent future incidents as the one that occurred. There were no similar incident reports, prior to this or after, available for LPA to review in children's records.

2nd incident occurred on 3/20/25 C2 was waking up from nap on his cot. C2 put his blanket away and tripped and hit their head. Parents were called and C2 was picked up.

No deficiencies cited today.

NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS. LPA observed Director Kristy Ford post notice of site visit.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2025
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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