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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105137
Report Date: 08/23/2023
Date Signed: 08/23/2023 03:50:23 PM

Document Has Been Signed on 08/23/2023 03:50 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:POWAY UNIFIED SCHOOL DISTRICT-GARDEN ROADFACILITY NUMBER:
376105137
ADMINISTRATOR:MICHELE WILSON-MANOSFACILITY TYPE:
850
ADDRESS:14614 GARDEN ROADTELEPHONE:
(858) 248-7507
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
08/23/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Kristie Spillane & Christine KutznerTIME COMPLETED:
04:15 PM
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On 08/23/23 at 2:20pm, Licensing Program Analyst (LPA), Samantha Clenista conducted an announced Pre-Licensing inspection. Upon arrival, LPA met with Preschool Operation Supervisors, Kristie Spillane and Christine Kutzner. All indoor and outdoor activity space utilized for the children were inspected today. Facility is requesting to be licensed for 24 preschoolers (ages 2-5 years old) in the Preschool Room. This facility is housed on the premises of Garden Road Elementary School. Fire clearance was granted on 08/17/2023. LPA informed Facility Representatives that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor play. When medications are on site, Ms. Spillane stated that they will be in a locked drawer cabinet near the teacher’s desk. Hours of operation are from Monday Thru Friday, 7:45am- 11:15am.

LPA continued to tour the facility and measured all indoor and outdoor activity space. Preschool Room measured at approximately 1,279.64 sq. ft., sufficient for 36 children. Room is equipped with 2 sinks and 1 toilet available for the children. There is a separate bathroom located in the “J3” building, where facility representatives will designate one stall for their preschool program. LPA observed a sign on the stall stating that it is solely for the use of preschool children. LPA observed all indoor play space to be complete with age-appropriate furniture and equipment, including tables, chairs, cubbies, bookshelves, and other activity supplies for the children. There is an operational carbon monoxide detector on site located in the classroom on top of a cabinet near the teacher’s desk. The sign-in and out area is located directly outside of the classroom.

The entire elementary school is fenced per regulation. There is a big playground and open area directly in front of the classroom which is separately fenced in. This area is designated for the school-aged children of the Elementary School (ages TK/Kinder). Facility is requesting that they share this playground with the school-age program at staggered times.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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
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: POWAY UNIFIED SCHOOL DISTRICT-GARDEN ROAD
FACILITY NUMBER: 376105137
VISIT DATE: 08/23/2023
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A playground waiver shall be submitted and approved prior to licensure. LPA measured the area and it measured at approximately 24,326 sq. ft., sufficient for 324 children. Facility Representatives stated their understanding that there should be no co-mingling between the preschool and school aged children at any given time. Area had a trees and gazebo used for shade. Area had age-appropriate toys and play equipment and had rubber turf under play structure, sufficient to sustain a fall. Drinking water is readily accessible inside and outside the classroom via water faucet and refillable water bottles. Facility had their water tested for lead on 02/16/2023, and no exceedance was found. See file for copy of results. Facility Representatives were reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

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

Facility Representatives were 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) tollfree ADA Information Line at (800) 514-0301 (voice) or (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
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: POWAY UNIFIED SCHOOL DISTRICT-GARDEN ROAD
FACILITY NUMBER: 376105137
VISIT DATE: 08/23/2023
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Facility Representatives were informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Prior to licensure, facility must obtain an approved playground waiver for them to share the TK/K playground at staggered times. Exit interview was conducted and report was reviewed with Facility Representatives, Kristie Spillane and Christine Kutzner. A notice of site visit was given to Facility Representatives and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. A license for 24 preschool children (ages 2-5 years old) in Preschool Room may be granted upon receiving the above corrections and after conducting a final file review. Facility Representatives stated they understand that this report shall be kept available at the facility for public review for 3 years.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
LIC809 (FAS) - (06/04)
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