376105047-12-18-2023-51-CC-SSIO-CYN3LM-20231218172058

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376105047
Report Date: 12/18/2023
Date Signed: 12/18/2023 05:21:07 PM

Document Has Been Signed on 12/18/2023 05:21 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:	PRIMROSE SCHOOLS 4S RANCH		FACILITY NUMBER:	376105047
ADMINISTRATOR:	BREEANNA MOTA		FACILITY TYPE:	830
ADDRESS:	17025 VIA DEL CAMPO		TELEPHONE:	(858) 592-2335
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92127
CAPACITY: 36	TOTAL ENROLLED CHILDREN: 36	CENSUS: 24	DATE:	12/18/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	03:40 PM
MET WITH:	Breeanna Mota		TIME COMPLETED:	05:25 PM

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 12/18/2023 at 3:40pm, Licensing Program Analyst, (LPA), Selina Siao conducted a case management inspection to follow up with two self reported incidents that happened on 11/10/2023 and 11/16/2023. Upon arrival, LPA Siao met with Director Breeanna Mota who was in the back office. LPA conducted a tour of the two infant classrooms to gather census. The following ratios were observed: Infant room had 12 infants supervised by staff members Elizabeth Kang, Christina Rosas Zaia and Carly Cruz. The Toddler 2 class had 12 children outside supervised by staff members Lidia Ojeda, Sek Young Choi, Areli Vigil and Noelle Ciavirella. Facility was within staffing ratio during the inspection. All staff members have the required background clearances and are associated to the facility. On 11/10/2023, a staff member fed another's child's bottle of milk to Infant #1. It was discovered by a parent during pick up as the number of bottles did not match the feeding report. The feeding report indicates that infant #1 had been fed three out of six bottles but there were four remaining bottles in the bag. During that time staff members looked into the matter and identified that infant #1 was fed the wrong bottle by going over the infant bottle counts. Facility informed both of the infants parents about the incident. Per Director the child did not have any allergic reaction from drinking infant #2's formula milk. As a result of the incident, both of the teachers that were responsible for the incident were re-educated on proper use of the infant bottle log, and the form was updated for clarity to help the teachers. The staff members involved were counseled and all infant staff members have been retrained on bottle tracking and feeding procedures during the all staff meeting on 11/18/2023. LPA Siao inspected the classrooms bottles today and the bottles are properly labeled with the child's name and the date.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023

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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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: PRIMROSE SCHOOLS 4S RANCH	FACILITY NUMBER: 376105047
	VISIT DATE: 12/18/2023

NARRATIVE

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The second incident happened on 11/16/2023 around 10:51am, a day care child from the toddler #1 class walked from the playground door towards his class without visual supervision during transition. During the incident there were two staff with eight children. Teacher #1 and teacher #2 decided that it was very windy and a bit chilly during outdoor time and about 15 minutes later, the staff members decided to transfer the children back into the classroom. Staff #1 opened the door to retrieve the transportation wagon and began buckling the non-ambulatory infants into their chairs. During that time child#1 went through the door and walked to his classroom without the teachers. The child was intercepted by staff #3 and was brought back to his teachers who were trying to transfer the children inside the classroom. Per Director the child was left without visual supervision for about a minute based on the information that she gathered from interviewing the staff members. After the incident, both of the teachers were disciplined and were reminded of the visual supervision. All staff members were also reminded about the visual supervision requirements and proper positioning during transition on 11/18/2023.

Please refer to the next page LIC 809D for citations issued. LPA will email the TSP (Technical Support Program) information to Director tomorrow. An exit interview was conducted, and appeal rights were provided. Notice of site visit was posted during the inspection and it shall remain posted for up to 30 days.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/18/2023 05:21 PM - It Cannot Be Edited

Created By: Selina Siao On 12/18/2023 at 04:16 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: PRIMROSE SCHOOLS 4S RANCH	FACILITY NUMBER: 376105047
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/18/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/19/2023 Section Cited CCR 101216.1(a)	1 2 3 4 5 6 7	Personnel Requirements- Child care center personnel shall be competent to provide the services necessary to meet the individual needs of children in care and shall at all times be employed in numbers sufficient to meet those needs. This requirement is not met as evidence by:	1 2 3 4 5 6 7	Director stated the staff members involved were counseled and all infant staff members has been retrained on bottle tracking and feeding procedures on 11/18/2023.
	8 9 10 11 12 13 14	On 11/10/2023, staff fed the wrong bottle of formula milk to infant #1. Infant #1 did not sustain any allergic reaction from drinking infant #2's formula milk. This poses a potential health and safety risk to children in care. This is a repeat violation that also happened on 04/05/2023.	8 9 10 11 12 13 14	Director provided the 11/18/2023 staff members sign in sheet and the agenda to LPA.
Type B 12/19/2023 Section Cited CCR101429(a)(1)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision for Infants- Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. This requirement is not met as evidence by:	1 2 3 4 5 6 7	During the facility's monthly staff meeting on 11/18/2023. Director and licensee reminded everyone about the visual supervision requirements and proper positioning during all transition.
	8 9 10 11 12 13 14	On 11/16/2023 around 10:51am, a day care child walked from the playground door towards his class without visual supervision for about a minute during the outdoor to indoor transition in the toddler 1 class. A staff brought the child back to his teachers at the playground that were trying to transfer the kids inside. This poses a potential health and safety risk to children.	8 9 10 11 12 13 14	Director provided the 11/18/2023 staff members sign in sheet and agenda to LPA.

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:

Tashima Daniel

LICENSING EVALUATOR NAME:

Selina Siao

LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2023

LIC809 (FAS) - (06/04)

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