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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600320
Report Date: 12/30/2019
Date Signed: 01/02/2020 03:59:17 PM

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:KINDERCARE CUYAMACA INFANTFACILITY NUMBER:
376600320
ADMINISTRATOR:MARITZA RENTERIAFACILITY TYPE:
830
ADDRESS:9735 CUYAMACA STREETTELEPHONE:
(619) 562-3423
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY:32CENSUS: 16DATE:
12/30/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Mariitza RenteriaTIME COMPLETED:
12:10 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Keturah Lane and Nancy Diaz arrived at the facility to conduct a case management inspection to follow up on a self-reported unusual incident that occurred on 12/12/19. LPAs met with Maritza Renteria, Director. The infant classroom (room number 1) had 4 infants present with one teacher. Room number 2 had 12 infants present with three aides and no qualified teacher was present. Required teacher to child ratio was not met.

Director self- reported an incident that occurred on 12/12/19 verbally by leaving a message on the duty line on 12/13/19 and filing a written report on 12/17/19. The incident resulted in a violation of Staff-Infant Ratio requirements. In the report, Director stated that a teacher (Staff #1) was left alone with 5-7 infants for a period of 30 minutes. (6:30 - 7:00AM). Two additional teachers arrived at 7:00AM.

See LIC 809D for deficiencies cited during today's inspection. Director was provided a copy of the appeal rights form LIC 9058 and the signature on this form acknowledges receipt of these rights.

Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.
THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.

The Notice of Site Visit (LIC 9213) was provided to be posted at the facility for 30 days. LPAs observed form LIC 9213 posted.

SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 12/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2019
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: KINDERCARE CUYAMACA INFANT
FACILITY NUMBER: 376600320
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/30/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/31/2019
Section Cited

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101416.5 Staff-Infant Ratio
(b) There shall be a ratio of one teacher for every four infants in attendance. This requirement is not met as evidenced by...
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- Based on interview and self-reported incident, the Director did not ensure proper ratio having 5-7 infants with one teacher in care for a 30-minute period. This poses an immediate health, safety and and personal rights risk to persons in care.
- Based on today's observation, room #2 was out of ratio with 12 infants and 3 aides. There was not a qualified teacher present. This poses an immediate health, safety and personal rights risk to persons 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:
DATE: 12/30/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/30/2019
LIC809 (FAS) - (06/04)
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