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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105112
Report Date: 01/23/2025
Date Signed: 01/23/2025 03:44:15 PM

Document Has Been Signed on 01/23/2025 03:44 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:ENCINITAS SHINING STARS INFANT CENTERFACILITY NUMBER:
376105112
ADMINISTRATOR/
DIRECTOR:		CORALITO GARCIAFACILITY TYPE:
830
ADDRESS:511 ENCINITAS BOULEVARD #114TELEPHONE:
(760) 436-5433
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: 9TOTAL ENROLLED CHILDREN: 9CENSUS: 8DATE:
01/23/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Coralito GarciaTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On 1/23/25 at 12:00 PM, Licensing Program Analysts (LPAs) Keturah Lane and Hanna Lucas visited the facility for another reason and while touring the facility observed a deficiency in the infant classroom. LPAs observed 8 infants (7 were sleeping) and C1 was observed sleeping on his stomach in a crib. Director stated that the child can roll over, but C1 did not have the individual infant sleeping plan updated and was observed sleeping on his stomach. Per TItle 22 regulations, infant sleeping plans need to be updated by the provider and parent the next day after a child is observed to be able to roll over. Pursuant to Title 22 of the CA Code of Regulations, the following Type B deficiency was cited (please refer to LIC809-D...)

Exit interview conducted and report was reviewed with facility representative Director Coralito Garcia. Notice of site visit was provided and must remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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 2
Document Has Been Signed on 01/23/2025 03:44 PM - It Cannot Be Edited


Created By: Keturah Lane On 01/23/2025 at 02:34 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: ENCINITAS SHINING STARS INFANT CENTER
FACILITY NUMBER: 376105112

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/30/2025
Section Cited
CCR
101430(a)(3)(A)(4)

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101430 Infant Care Activities (a)(3) All infants shall be given the opportunity to sleep without distraction or disturbance... Upon staff observation that the infant is capable of rolling from their back to their stomach and stomach to their back, the provider shall fill out Section D of the Individual Infant Sleeping Plan [LIC 9227 (3/20)], notify the authorized representative, and obtain the authorized representative's signature on the Individual Infant Sleeping Plan no later than the next business day following observation. This was not met as evidenced by...
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Director will provide updated LIC9227 form signed by provider and parent that C1 can roll over from back to stomach and stomach to back no later than 1/30/25 and submit to LPA Lane by e-mail: Keturah.Lane@dss.ca.gov. Director will hold a training for all infant staff to explain how to properly fill out the LIC9227 form in a timely manner as required by regulation and send staff agenda with signatures.
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Based upon LPA observation that C1 was sleeping on his stomach and record review of the child's LIC9227 Individual Infant Sleeping Plan was not updated to show that the child can roll over by the next business day is a potential health, safety and personal rights risk to children in care.
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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:Tashima Daniel
LICENSING EVALUATOR NAME:Keturah Lane
LICENSING EVALUATOR SIGNATURE:
DATE: 01/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/23/2025


LIC809 (FAS) - (06/04)
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