<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600599
Report Date: 08/11/2023
Date Signed: 08/11/2023 02:11:37 PM

Document Has Been Signed on 08/11/2023 02:11 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:PALOMAR COMM. COLL. DIST. ECE LAB SCHOOL ESCONDIDOFACILITY NUMBER:
376600599
ADMINISTRATOR:LISA CASASFACILITY TYPE:
850
ADDRESS:1951 EAST VALLEY PARKWAYTELEPHONE:
(760) 744-1150
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 15DATE:
08/11/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lisa CasasTIME COMPLETED:
02:30 PM
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 11, 2023, at 1PM Licensing Program Analyst (LPA) William Chancellor arrived unannounced to the facility to conduct a case management visit due to an unusual incident report received for an incident that occurred on 7/14/23. This incident involved child (C1) running across the classroom and kicking the block furniture, resulting in a broken foot and requiring a cast.

LPA met with DIrector Lisa Casas and conducted a tour of the facility taking census of the facility. Present during inspection were 15 children and each classroom had two teachers. During the visit, LPA conducted interviews with DIR and S1, who were present in the classroom during the incident. C1 was not present during todays inspection. Interviews and record review revealed the staff were in ratio at the time of the incident and S1 observed C1 injured their foot due to kicking the furniture. Staff did notify C1's parents of the incident immediately and child was picked up and taken to the hospital.

LPA determined that the facility was not in violation of Title 22 Regulations.

An exit interview was conducted, a copy of this report, LIC 811 (Confidential Names List) and appeal rights were reviewed with and provided to Director Lisa Casas.

A notice of site visit was also provided and must remain posted for 30 days.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2023
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 1