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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600517
Report Date: 07/07/2025
Date Signed: 07/08/2025 08:57:46 AM

Document Has Been Signed on 07/08/2025 08:57 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:KLASSIC KIDS DAY CARE - LOMA PORTALFACILITY NUMBER:
376600517
ADMINISTRATOR/
DIRECTOR:		AMBER CUTTINGFACILITY TYPE:
840
ADDRESS:3341 BROWNING STREETTELEPHONE:
(858) 265-9827
CITY:SAN DIEGOSTATE: CAZIP CODE:
92106
CAPACITY: 112TOTAL ENROLLED CHILDREN: 112CENSUS: 25DATE:
07/07/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Susan Hansen, Site DirectorTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 7/7/2025, at 1:20pm., Licensing Program Analyst (LPA) Cindy Meier conducted an unannounced case management inspection regarding a self reported incident. LPA met with Facility Representative, Site Director, Susan Hansen. LPA discussed the purpose of the inspection and was led on a tour of the facility. There were twenty-five (25) children present with four (4) staff members.

Site Director, Susan Hansen reported to Community Care Licensing that on 6/12/2025 at
11:45am there were twenty-four (24) children playing outside with two (2) staff supervising, when child #1 (C1) who was playing on the monkey bars on the climbing structure, lost their grip, fell and landed on their right arm. Staff #1 (S1) stated she was approximately 3 feet away when C1 fell. S1 attended to C1 and escorted C1 to the classroom for further evaluation and first aid. Staff #2 (S2) remained with the other children and Staff #3 went to the playground to assist the supervision and ratio.

C1’s parents were notified and C1 was picked up later in the day. Staff administered first aid to C1 until the parents picked up C1. C1 was later evaluated at the hospital and diagnosed with a fractured arm.

LPA observed the climbing structure and monkey bars and made note of the manufacturer’s label on the structure stating the equipment is designed and appropriate for ages 5 – 12. C1 is younger than 5 years of age.

Due to the manufacturer’s age restriction label, the facility was out of compliance which poses an immediate risk to the health, safety, or personal rights of children in care as C1 was younger than 5 years of age.
NAME OF LICENSING PROGRAM MANAGER: Jason Garay
NAME OF LICENSING PROGRAM ANALYST: Cindy Meier
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: KLASSIC KIDS DAY CARE - LOMA PORTAL
FACILITY NUMBER: 376600517
VISIT DATE: 07/07/2025
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Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, one (1) Type A deficiency was cited; see LIC809D.

LPA Cindy Meier informed Facility Representative, Site Director, Susan Hansen that this report dated 7/7/25 document(s) one (1) Type A citation(s) which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Cindy Meier informed the Facility Representative, Site Director, Susan Hansen to provide a copy of this licensing report dated 7/7/25 that documents a Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months

A copy of this report was reviewed and given to Facility Representative, Site Director, Susan Hansen.
A Notice of Site Visit was provided and is required to be posted for 30 days.
Exit interview conducted with Facility Representative, Site Director, Susan Hansen.
NAME OF LICENSING PROGRAM MANAGER: Jason Garay
NAME OF LICENSING PROGRAM ANALYST: Cindy Meier
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/08/2025 08:57 AM - It Cannot Be Edited


Created By: Cindy Meier On 07/07/2025 at 01:56 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: KLASSIC KIDS DAY CARE - LOMA PORTAL
FACILITY NUMBER: 376600517

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/07/2025
Section Cited
CCR
101239(m)

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101239 Fixtures, Furniture, Equipment and Supplies
(m)All play equipment and materials used by children shall be age appropriate.

This requirement is not met as evidenced by:
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Site Director communicated with staff that they will no longer use the climbing structure. Licensee and Site Director will develop written policies regarding age restrictions for the climbing structures and submit to staff to ensure the manufacturer's label is adhered to.

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Based on observation and interview, the facility did not comply with the above regulation, as a child younger than 5, played on the climbing structure which the manufacturer’s label states appropriate for 5-12 years of age and resulted in a child receiving an injury which poses an immediate Health and Safety 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.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Cindy Meier
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/07/2025


LIC809 (FAS) - (06/04)
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