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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600320
Report Date: 06/07/2023
Date Signed: 06/07/2023 04:44:38 PM

Document Has Been Signed on 06/07/2023 04:44 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:KINDERCARE CUYAMACA INFANTFACILITY NUMBER:
376600320
ADMINISTRATOR:MONICA COLLINSFACILITY TYPE:
830
ADDRESS:9735 CUYAMACA STREETTELEPHONE:
(619) 562-3423
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 21DATE:
06/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Haley AdamsTIME COMPLETED:
05:00 PM
NARRATIVE
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On 6/7/23 at 12:00 PM, Licensing Program Analyst (LPA) Keturah Lane visited the facility to conduct an annual inspection. Upon arrival LPA met with Assistant Director Haley Adams and proceeded to tour the facility. During today's inspection, there were 21 infants/toddlers. LPA observed infants/toddlers sleeping during naptime. Facility was following naptime ratios. Census was as follows:

· 5 infants in Room 1 with staff members Andrea Flaherty and Emily Elliott (Morris)
· 8 infants (mobile) in Room 2 with staff member MaryLou Glover
· 8 toddlers in Room 3 with staff member Sarah Tucker

Appropriate ratios and capacity were observed. Appropriate care & visual supervision were also observed during the inspection while children were napping.

Furniture and age appropriate equipment is in good condition. Rooms have adequate heating, lighting, ventilation. Floors appear to be clean and safe. Drinking water is readily accessible. Bathrooms are maintained with operational toilets and faucets with appropriate temperature. Paper towels and toilet paper are available. Bathroom is lighted and has ventilation. Food service area consists of a kitchen which is clean and free of hazards. Menu is posted. Adequate food is available for meals. Cleaning supplies are kept separate from food and are inaccessible to children. Storage containers for solid waste have tight-fitting covers and are kept in good repair. Storage areas for poisons are locked. Director stated there are no firearms or other weapons on the premises. All foods/beverages capable of rapid spoiling are stored in covered containers at 45 F or less. The facility appears to be free of insects and rodents. There is an operational carbon monoxide detector at the facility. (continued on LIC809-C...)
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2023
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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: KINDERCARE CUYAMACA INFANT
FACILITY NUMBER: 376600320
VISIT DATE: 06/07/2023
NARRATIVE
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Outdoor play area is a fenced playground with sufficient material for cushioning. There are no bodies of water at this facility. Climbing structures, swings and slides are securely fixed to the ground. Area has canopies and trees used for shade. Equipment is age appropriate. Area has drinking water readily accessible and grounds are free of debris or potential hazards.

There is no medication currently on file for enrolled infants/toddlers. Personnel records contain health screening documentation and at least one staff member has current CPR and First Aid certifications. Three staff members did not renew mandated reporter training. One staff member did not have required immunizations available for review at the facility. Infant care teachers meet educational requirements. Sign ins were reviewed through the Kindercare app. Children’s records contain admission agreements and medical assessment. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Facility representative was reminded that all adults 18 and over, 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.

All infant furniture & equipment are age appropriate and in good repair. There are no walkers, bouncy seats, exersaucers or jumpers in the room. Feeding tables have broad-based legs, plastic seats in good repair. Hazardous materials are inaccessible to children. Bottles, dishes and containers of food brought by infant’s authorized representative are labeled with the infant’s name and current date. The changing table is within arm's reach of sink. There is at least 1 potty chair or toilet for every 5 infants being toilet trained. Caregivers wash hands before and after each feeding and each diaper change. Toys are safe, with no sharp edges, splinters or protruding points, nor small parts that can be pulled off and swallowed. Floor mats and cots are available for infants able to climb out of cribs. Cribs or napping equipment are available. Bedding is identified and stored separately for each infant. Napping infants are under visual observation by staff. Indoor activity space is physically separate from other components. One enrolled child did not have Infant Needs and Services Plan or Individual infant sleeping plan on file. (continued on LIC809-C...)
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
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
VISIT DATE: 06/07/2023
NARRATIVE
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LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

Pursuant to Title 22 of the CA Code of Regulations, the following Type B deficiencies were cited (refer to LIC 809-D).

Exit interview conducted and report was reviewed with the facility representative Assistant Director Haley Adams. A notice of site visit was given and must remain posted for 30 days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 06/07/2023 04:44 PM - It Cannot Be Edited


Created By: Keturah Lane On 06/07/2023 at 04:10 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: KINDERCARE CUYAMACA INFANT

FACILITY NUMBER: 376600320

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 06/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in one out of four staff files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/21/2023
Plan of Correction
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Assistant Director stated she will e-mail proof of immunizations for staff member (S1) by 6/21/23 to LPA Lane at: Keturah.Lane@dss.ca.gov
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 3 out of 4 staff files reviewed which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/21/2023
Plan of Correction
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Assistant Director stated she would send completed mandated reporter certificates to LPA Lane via e-mail by 6/21/23 for staff members S1, S2 and S3
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 Cuddy
LICENSING EVALUATOR NAME:Keturah Lane
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2023


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 06/07/2023 04:44 PM - It Cannot Be Edited


Created By: Keturah Lane On 06/07/2023 at 04:10 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: KINDERCARE CUYAMACA INFANT

FACILITY NUMBER: 376600320

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 06/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101419.2(a)
Infant Needs and Services Plan
(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1 out of 21 children's records which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/21/2023
Plan of Correction
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Assistant Director stated she would provide completed infant needs and servicse plan for child C1 via e-mail to LPA Lane by 6/21/23.
Type B
Section Cited
CCR
101419.2(b)(2)
Infant Needs and Services Plan
(b) The needs and services plan shall be in writing and shall include the following: (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1 out of 21 children's records which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/21/2023
Plan of Correction
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Assistant Director stated she would provide completed LIC9227 infant sleep plan for child (C1) via e-mail to LPA Lane by 6/21/23
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 Cuddy
LICENSING EVALUATOR NAME:Keturah Lane
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2023


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