376105113-8-26-2022-51-CC-GCUS-CHNPK9-20220826112245

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376105113
Report Date: 08/26/2022
Date Signed: 08/26/2022 11:22:51 AM

Document Has Been Signed on 08/26/2022 11:22 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	CLAIREMONT CANYONS ACADEMY STATE PRESCHOOL		FACILITY NUMBER:	376105113
ADMINISTRATOR:	VICTORIA PETERSON		FACILITY TYPE:	850
ADDRESS:	4133 MT ALBERTINE AVENUE		TELEPHONE:	(619) 605-1350
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92111
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 0	DATE:	08/26/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:36 AM
MET WITH:	Victoria Peterson		TIME COMPLETED:	11:30 AM

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 August 26, 2022 at 9:35 a.m. Licensing Program Analyst (LPA) Leilani Curtis, conducted an announced Change of Location inspection. LPA met with school principal/site director Victoria Peterson who has a valid preschool through grade school administrative credential and meets qualification requirements. Also present was Josephine Condra, project resource teacher. This is a Title V State funded preschool program which is located within Clairemont Canyons Academy Elementary School. There will be two half-day sessions available. A first aid kit and medications will be stored in classroom #810. A fire clearance for a capacity of 24 children was granted on 8/23/22. The program will occupy the following room which was inspected and measured today: Room #810 measures 1248.93 square feet. Total indoor activity space is 1248.93 square feet, which will accommodate a total of 35 children. Age-appropriate supplies and equipment were observed available in all indoor and outdoor activity spaces. Cleaning supplies and other toxic items are inaccessible to children through latches, locks and/or placed on high surfaces. There is an operational carbon monoxide detector located in the classroom. Children will bring water bottles from home which staff will refill using bottled water or at a campus water bottle filling station. Children's bathrooms are located in the classroom. There are 2 toilets and 2 sinks, which are sufficient for 30 children. Step stools are in place under the sinks. The children shall be escorted and supervised at all times, including bathroom times. There are multiple staff restrooms located throughout the facility. Isolation area is located in the nurse’s office. The playground is complete with a surrounding fence 4 feet in height, and age appropriate equipment. Shade is provided by a canopy/shade sail. The entire outdoor space measures 5657.50 square feet and is sufficient to accommodate 75 children. The director states that the facility will install a climbing play structure in the future. The director understands that the new play structure will need to be inspected and approved prior to it's use.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CLAIREMONT CANYONS ACADEMY STATE PRESCHOOL	FACILITY NUMBER: 376105113
	VISIT DATE: 08/26/2022

NARRATIVE

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This facility plans to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No corrections are needed. A license for a capacity of 24 children is granted and effective 8/29/22.

Exit interview conducted and report was reviewed with the principal, Victoria Peterson.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

LIC809 (FAS) - (06/04)

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