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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105046
Report Date: 03/01/2023
Date Signed: 03/01/2023 04:45:15 PM

Document Has Been Signed on 03/01/2023 04:45 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:PRIMROSE SCHOOLS 4S RANCHFACILITY NUMBER:
376105046
ADMINISTRATOR:BREEANNA MOTAFACILITY TYPE:
850
ADDRESS:17025 VIA DEL CAMPOTELEPHONE:
(858) 592-2335
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY: 164TOTAL ENROLLED CHILDREN: 63CENSUS: 54DATE:
03/01/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:46 PM
MET WITH:Breeanna MotaTIME COMPLETED:
05:00 PM
NARRATIVE
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On 3/1/2023 at 2:46pm, Licensing Program Analyst (LPA) Selina Siao conducted a case management visit to follow-up on two incidents where a child was found at the playground. Upon arrival, LPA met with Director Breeanna Mota. Appropriate ratio was observed during the tour of the five preschool classrooms. Staff present has the required criminal background clearances and are associated to the facility.

Both incidents were self reported and it was reported timely. The first incident occurred on 2/07/2023 around 5pm with the Pre-K 2 classroom. During transition from the playground to the classroom, a 3 year old day care child (Child 1/C1) ran back to the playground after the headcount at the playground. Almost immediately the Early Preschool 1 (EPS 1) kids went out to the playground and the staff in the EPS 1 observed C1 was hiding and playing under the play structure. The EPS staff invited C1 to join her class. According to the information obtained during the incident there were 12 children in the Pre-K 2 supervised by 1 staff. The incident was reported to the parent verbally. Since the incident, facility provided name to face head count training with staff members on 02/20/2023.

The second incident occurred on 02/27/2023 at 12:15pm in the two year old classroom and the child (Child 2/C2) was observed at the toddler playground alone. Based on information obtained, the lead teacher (Staff 1/S1) did a face to name head count at 11:53am and C2 was present. At 12:04pm, the lead teacher was relieve to take her break by another teacher (Staff 2/S2) and took over the diaper change responsibility without doing a face to name headcount on the ipad. At 12:15pm, a staff next door in the toddler room staff 3/S3 observed C2 out on the playground and she brought the child back into the 2 yo classroom next door. Staff 2 check the child to ensure that he was not injured. The child's parent was contacted after the incident as the child has a history of trying to leave the classroom but

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/01/2023
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 3
Document Has Been Signed on 03/01/2023 04:45 PM - It Cannot Be Edited


Created By: Selina Siao On 03/01/2023 at 11:25 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: PRIMROSE SCHOOLS 4S RANCH
FACILITY NUMBER: 376105046

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/08/2023
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision
No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Director tated that she provide the Primrose face to name policy and procedure during today's inspection to staff members. She will be ordering safety gates for the preschool rooms that leads to the playground to ensure children's safety.
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This requirement is not met as evidence by: A 3 year old child was left without supervision at the playground on 2/7/2023 and a 2 year old child got out of the class onto the connected toddler playground and was returned to class by a toddler staff on 2/27/23. This poses a potential health and safety risk to clients in care.
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Director will sumit the written plan of correction to LPA no later than 3/06/2023 that shows that she took the above corrections and submit pictures showing that the gates are installed by 03/08/2023. Facility has also hired additional staff members to ensure that the children's needs are met.

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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: 03/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2023


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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: PRIMROSE SCHOOLS 4S RANCH
FACILITY NUMBER: 376105046
VISIT DATE: 03/01/2023
NARRATIVE
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this is the first time that the child made it outside. The child was picked up around 4pm by the parent.

See LIC809D for citation issued. Exit interview conducted with facility representative. Notice of site visit was posted and it must remain posted for 30 days. Provided appeal rights.

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC809 (FAS) - (06/04)
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